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Nursing Home Quality Indicators: Their Uses and Limitations

Quality indicators (QI) are markers of potentially poor or excellent health care quality. They may include such elements as mortality rates, avoidable complications, and various measures of health care processes, such as implementation of effective treatment protocols.

Today, QI are being developed and used for a broad range of purposes in nursing homes and related facilities, such as assisted living. The federal government and many states plan to rely on QI as part of newer systems for monitoring and regulating nursing home quality of care. Although innovations that might improve nursing home quality are viewed positively, there are concerns about potentially inappropriate uses of QI. This paper describes the development of the federally sponsored nursing home QI, discusses a variety of applications of QI, and identifies issues and concerns regarding the use of QI.

This paper is intended to help policymakers and others assess proposed uses of quality indicators; understand the current state-of-the-art, including issues such as reliability, validity, and risk adjustment; and understand the potentially promising uses and substantial limitations of quality indicators. (55 pages)

—from the Executive Summary to the AARP Public Policy Institute Issue Paper by Barbara Manard, Ph.D.

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