Public reporting and the quality of care of German nursing homes

Abstract Objectives Since 2009, German nursing homes have been evaluated regularly by an external institution with quality report cards published online. We follow recent debates and argue that most of the information in the report cards does not reliably measure quality of care. However, a subset o...

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Bibliographic Details
Published in:Health policy (Amsterdam) 2016-10, Vol.120 (10), p.1162-1170
Main Authors: Herr, Annika, Nguyen, Thu-Van, Schmitz, Hendrik
Format: Article
Language:English
Subjects:
Electronic publishing
Germany
Health administration
Humans
Information
Institutional change
Internal Medicine
Internet
Long-term care
Mandatory Reporting
Nursing homes
Nursing Homes - organization & administration
Nursing Homes - standards
Outcome and Process Assessment (Health Care) - methods
Outcome and Process Assessment (Health Care) - statistics & numerical data
Policy making
Public reporting
Quality
Quality Improvement - standards
Quality Improvement - statistics & numerical data
Quality management
Quality of care
Quality of Health Care - standards
Risk Factors
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Summary:Abstract Objectives Since 2009, German nursing homes have been evaluated regularly by an external institution with quality report cards published online. We follow recent debates and argue that most of the information in the report cards does not reliably measure quality of care. However, a subset of up to seven measures does. Do these measures that reflect “risk factors” improve over time? Method Using a sample of more than 3000 German nursing homes with information on two waves, we assume that the introduction of public reporting is an exogenous institutional change and apply before–after-estimations to obtain estimates for the relation between public reporting and quality. Results We find a significant improvement of the identified risk factors. Also, the two employed outcome quality indicators improve significantly. The improvements are driven by nursing homes with low quality in the first evaluation. Conclusion To the extent that this can be interpreted as evidence that public reporting positively affects the (reported) quality in nursing homes, policy makers should carefully choose indicators reflecting care-sensitive quality.
ISSN:0168-8510
1872-6054
DOI:10.1016/j.healthpol.2016.09.004