Abstract
Over the last two decades, there has been growing interest in comparative performance evaluation of health institutions. Small hospitals and small nursing home facilities might have too few eligible cases for sufficiently precise comparisons in a single year (or other standard reporting period). An analyst might be tempted to use the smaller standard error estimates obtained under the finite population sampling model (FPSM), rather than those obtained under a superpopulation model. We argue that the FPSM does not properly represent the reliability of quality profiling information in such situations . We consider alternative methods for obtaining adequately precise profiles for small institutions, including moving averages and hierarchical models.
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Acknowledgements
The work reported in this paper was conducted as part of the CAHPS II project and funded by the Agency for Health Care Quality and Research (AHQR) and the Health Care Financing Administration through cooperative agreements with Harvard Medical School (HS09205) and RAND (HS00924). The authors thank project officers Chris Crofton, Chuck Darby, Beth Kosiak, and Marybeth Farquhar for their active participation and helpful suggestions throughout the project and members of the CAHPS consortium for their role in the design and implementation of the data collection activities. The authors would like to thank Dan McCaffrey, Ph.D. for his comments on an earlier version of this manuscript and Colleen Carey, B. A. for her help in the preparation of the manuscript.
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Elliott, M.N., Zaslavsky, A.M. & Cleary, P.D. Are finite population corrections appropriate when profiling institutions?. Health Serv Outcomes Res Method 6, 153–156 (2006). https://doi.org/10.1007/s10742-006-0011-2
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DOI: https://doi.org/10.1007/s10742-006-0011-2