Making difficult decisions: the role of quality of care in choosing a nursing home

• Published in: American journal of public health (1971) Vol. 103; no. 5; pp. e31 - e37
• Main Authors: Pesis-Katz, Irena, Phelps, Charles E, Temkin-Greener, Helena, Spector, William D, Veazie, Peter, Mukamel, Dana B
• Format: Journal Article
• Language: English
• Published: United States American Public Health Association 01-05-2013
• Subjects: Activities of daily living; Aged; Aged, 80 and over; Aging; California; Choice Behavior; Clinical Competence - standards; Competition; Consumer behavior; Consumers; Financing, Personal; Health Facility Environment - standards; Health Policy; Health Service Delivery; Health Services Accessibility; Hospitals; Hotels & motels; Humans; Information Dissemination; Logistic Models; Medicaid; Medicare; New York; Nursing; Nursing homes; Nursing Homes - standards; Ohio; Older people; Online Research and Practice; Ownership; Physical restraints; Pressure ulcers; Public health; Public Health Practice; Quality Indicators, Health Care; Quality of Health Care - standards; Quality of Life; Studies; Texas; New York; Ohio; California; Texas
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2013.301243

We investigated how quality of care affects choosing a nursing home.
We examined nursing home choice in California, Ohio, New York, and Texas in 2001, a period before the federal Nursing Home Compare report card was published. Thus, consumers were less able to observe clinical quality or clinical quality was masked. We modeled nursing home choice by estimating a conditional multinomial logit model.
In all states, consumers were more likely to choose nursing homes of high hotel services quality but not clinical care quality. Nursing home choice was also significantly associated with shorter distance from prior residence, not-for-profit status, and larger facility size.
In the absence of quality report cards, consumers choose a nursing home on the basis of the quality dimensions that are easy for them to observe, evaluate, and apply to their situation. Future research should focus on identifying the quality information that offers the most value added to consumers.