Abstract:
OBJECTIVE:To demonstrate the value of shrinkage estimators when calculating a composite quality measure as the weighted average of a set of individual quality indicators. DATA SOURCES:Rates of 28 quality indicators (QIs) calculated from the minimum dataset from residents of 112 Veterans Health Administration nursing homes in fiscal years 2005-2008. STUDY DESIGN:We compared composite scores calculated from the 28 QIs using both observed rates and shrunken rates derived from a Bayesian multivariate normal-binomial model. PRINCIPAL FINDINGS:Shrunken-rate composite scores, because they take into account unreliability of estimates from small samples and the correlation among QIs, have more intuitive appeal than observed-rate composite scores. Facilities can be profiled based on more policy-relevant measures than point estimates of composite scores, and interval estimates can be calculated without assuming the QIs are independent. Usually, shrunken-rate composite scores in 1 year are better able to predict the observed total number of QI events or the observed-rate composite scores in the following year than the initial year observed-rate composite scores. CONCLUSION:Shrinkage estimators can be useful when a composite measure is conceptualized as a formative construct.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Shwartz M,Peköz EA,Christiansen CL,Burgess JF Jr,Berlowitz Ddoi
10.1111/j.1475-6773.2012.01437.xsubject
Has Abstractpub_date
2013-02-01 00:00:00pages
271-89issue
1eissn
0017-9124issn
1475-6773journal_volume
48pub_type
杂志文章abstract::A location model is used to determine the most efficient (i.e., least-cost) number and location of ambulance facilities in a rural area. The model incorporates response time and service time standards into the analysis and indicates the trade-off between costs and various time standards. The financial feasibility of i...
journal_title:Health services research
pub_type: 杂志文章
doi:
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journal_title:Health services research
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doi:
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journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1998-06-01 00:00:00
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journal_title:Health services research
pub_type: 杂志文章
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journal_title:Health services research
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doi:
更新日期:1990-10-01 00:00:00
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doi:10.1111/j.1475-6773.2010.01122.x
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doi:
更新日期:1995-10-01 00:00:00
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journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
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更新日期:2009-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00726.x
更新日期:2007-12-01 00:00:00
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journal_title:Health services research
pub_type: 杂志文章
doi:
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