Will Quality Measures Debunk Quality Care in the Nursing Home Industry?

Will Quality Measures Debunk Quality Care in the Nursing Home Industry?

Elaine R. Winston, Alexander Pelaez, B. Dawn Medlin
Copyright: © 2021 |Pages: 11
DOI: 10.4018/IJPPPHCE.2021010102
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Abstract

This research analyzes publicly available information on the quality of services delivered by healthcare organizations. The accessibility and transparency of healthcare data is exponentially growing. Due to the complexity of different provider groups in healthcare, the focus is on the nursing home industry. A key objective of this research is to explore any association among the government-defined quality ratings, cost-effectiveness, and quality care provided by a nursing home. Quality and performance metrics for all nursing homes that receive reimbursements from CMS is in the public domain. The CMS purports that nursing homes with high overall star ratings provide excellent healthcare to their residents. A surprising result from this study found high-quality-rated nursing homes with more nurse hours per resident provided lower quality care than nursing homes, which had lower nursing hours per resident. The research also suggests that healthcare organizations, such as nursing homes, acquire business analytics (BA) capabilities for specific government metrics.
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Literature Review

Numerous articles concerning a review of the literature on business analytics in healthcare and the importance of valid data within the healthcare industry. Digital data and information (Khajeheian, et al., 2018) in the healthcare industry continues to grow extensively (Ustundag and Cevikcan, 2017). The researchers conducted a Google Scholar search on academic article related to business analytics in healthcare in April 2020 and found a response rate of over 133,000 articles. In comparison, the same search was conducted in November 2016 and found slightly over 17,000 results, thus addressing the importance of this topic. The researchers also examined and summarized the literature surrounding the development of government-defined quality and performance metrics specifically related to nursing home health care.

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