The Relationship between Costs and Quality in Veterans Health Administration Community Living Centers: An Analysis Using Longitudinal Data

Health Services Research
James F BurgessJennifer L Sullivan

Abstract

To examine the relationship between cost and quality in Veterans Health Administration (VA) nursing homes (called Community Living Centers, CLCs) using longitudinal data. One hundred and thirty CLCs over 13 quarters (from FY2009 to FY2012) were studied. Costs, resident days, and resident severity (RUGs score) were obtained from the VA Managerial Cost Accounting System. Clinical quality measures were obtained from the Minimum Data Set, and resident-centered care (RCC) was measured using the Artifacts of Culture Change Tool. We used a generalized estimating equation model with facilities included as fixed effects to examine the relationship between total cost and quality after controlling for resident days and severity. The model included linear and squared terms for all independent variables and interactions with resident days. With the exception of RCC, all other variables had a statistically significant relationship with total costs. For most poorer performing smaller facilities (lower size quartile), improvements in quality were associated with higher costs. For most larger facilities, improvements in quality were associated with lower costs. The relationship between cost and quality depends on facility size and current level...Continue Reading

References

Jan 12, 2000·Medical Care·D B Mukamel, W D Spector
Mar 19, 2003·International Journal of Geriatric Psychiatry·David R Zimmerman
Aug 28, 2003·Health Care Management Review·Robert Weech-MaldonadoVince Mor
Oct 6, 2005·The Milbank Quarterly·Vincent Mor
Dec 7, 2005·Health Economics·Suthathip Yaisawarng, James F Burgess
Jan 13, 2006·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Robert Weech-MaldonadoVincent Mor
May 30, 2007·Health Affairs·Charles N KahnSusan Van Gelder
Mar 20, 2009·Annual Review of Public Health·Kenneth W Kizer, R Adams Dudley
Jun 30, 2009·Journal of the American Medical Directors Association·E Foy White-ChuPhilip Sloane
Jul 16, 2010·The Gerontologist·Nicholas G Castle, Jamie C Ferguson
Sep 4, 2010·Academic Medicine : Journal of the Association of American Medical Colleges·Donald M Berwick, Jonathan A Finkelstein
Jun 22, 2012·Health Services Research·Michael ShwartzDan Berlowitz
Jan 2, 2013·Annals of Internal Medicine·Peter S HusseyAteev Mehrotra
Dec 3, 2015·The Milbank Quarterly·Michael ShwartzAmy K Rosen

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