Families' and Residents' Perspectives of the Quality of Nursing Home Care: Implications for Composite Quality Measures.

Objectives: To assess (1) the relationship of consumers' assessment of overall nursing home quality to their assessment of specific dimensions of quality; and (2) the implications of this relationship for composite quality measures in Nursing Home Compare.
Design: A survey conducted in 2017 elicited respondents' assessments of the quality of overall care and 13 specific dimensions of care.
Settings and Participants: The sample consisted of 4449 respondents who either resided in a nursing home or had a family member who resided in a nursing home during the 6 months before the survey.
Methods: We estimated regression models to infer the relationship between consumers' assessments of overall quality and 13 specific dimensions of quality. The regression coefficients, indicating the implicit importance/weight assigned by respondents to each dimension as a component of the consumers' assessment of overall quality, were used to create a prototype composite quality measure.
Results: For long-stay residents, 8 of the 13 quality dimensions were significantly associated with their overall ratings of quality. Five dimensions achieved significance for short-stay residents. The magnitude of importance weights varied substantially across dimensions of care.
Conclusions and Implications: Our findings suggest that Nursing Home Compare could be improved by augmenting the technical information in the 5-Star composite measure with consumers' assessments of the additional, nontechnical dimensions of quality.
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