This is of particular importance for long-term stay residents of nursing homes who are both vulnerable and dependent on the care provided by their residential facilities. T here is considerable national interest in measuring the quality of health care outcomes. Such reform could better help users find nursing homes of higher quality and stimulate homes to improve quality in ways that benefit residents. Nursing Home Compare Star rankings could benefit by incorporating outcomes measures such as preventable hospitalizations and ED visits, and by comparing nursing home performance on results drawn from across states rather than within them. This study found that (1) the likelihood of potentially preventable events increases with increasing burden of chronic illness, (2) the principle reasons for hospital admissions and ED visits (eg, septicemia, pneumonia, confusion, gastroenteritis) are not part of existing nursing home quality measures, (3) the rate of potentially preventable admissions and ED visits for nursing homes residents varies greatly both across and within states, with 5 states having in excess of 20% more than the national average for both, and (4) the Nursing Home Compare Stars measure has limited correlation with rates of these potentially preventable events. The authors determined the rates and types of 2 important clinical outcomes–potentially preventable hospital admissions and potentially preventable emergency department (ED) visits–for a subset of 439,011 long-term nursing homes residents residing in 12,883 nursing homes throughout the United States over a 2-year period (2010–2011) and compared them with the Star Rating system. Nursing Home Compare Star Ratings are provided by Medicare to help select better nursing home care. Measurement of the quality of US health care increasingly emphasizes clinical outcomes over clinical processes.
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