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Using Multilevel Modeling to Assess Case-Mix Adjusters in Consumer Experience Surveys in Health Care

Datos Bibliográficos

ID9101574
AutoresOlga C Damman (0000-0002-4482-5042, Netherlands Institute for Health Services Research, autor de correspondencia), Janine H Stubbe (Netherlands Institute for Health Services Research, autor de correspondencia), Michelle Hendriks (0000-0002-7924-6294, Netherlands Institute for Health Services Research, autor de correspondencia), Onyebuchi A Arah (0000-0002-9067-1697, University of Amsterdam), Peter Spreeuwenberg (Netherlands Institute for Health Services Research, autor de correspondencia), Diana Delnoij (0000-0002-2066-9604), Diana M J Delnoij, Peter P Groenewegen, Peter Groenewegen (0000-0003-2127-8442, Utrecht University, autor de correspondencia)
Año2009
Volumen47
Número4
Páginas496-503
Fecha de publicación2009-04-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e31818afa05
PMID19238105
OpenAlexW1983407233
IdiomaEN
Citas recibidas7
Referencias citadas31

BACKGROUND: Ratings on the quality of healthcare from the consumer's perspective need to be adjusted for consumer characteristics to ensure fair and accurate comparisons between healthcare providers or health plans. Although multilevel analysis is already considered an appropriate method for analyzing healthcare performance data, it has rarely been used to assess case-mix adjustment of such data. The purpose of this article is to investigate whether multilevel regression analysis is a useful tool to detect case-mix adjusters in consumer assessment of healthcare. METHODS: We used data on 11,539 consumers from 27 Dutch health plans, which were collected using the Dutch Consumer Quality Index health plan instrument. We conducted multilevel regression analyses of consumers' responses nested within health plans to assess the effects of consumer characteristics on consumer experience. We compared our findings to the results of another methodology: the impact factor approach, which combines the predictive effect of each case-mix variable with its heterogeneity across health plans. RESULTS: Both multilevel regression and impact factor analyses showed that age and education were the most important case-mix adjusters for consumer experience and ratings of health plans. With the exception of age, case-mix adjustment had little impact on the ranking of health plans. CONCLUSIONS: On both theoretical and practical grounds, multilevel modeling is useful for adequate case-mix adjustment and analysis of performance ratings

Case mix index · Data science · Economic growth · Economics · Health care · Multilevel model · Computer Science · Customer Service Quality and Loyalty · Medicine · Nursing · Patient Satisfaction in Healthcare · Primary Care and Health Outcomes · Psychology

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Obras citantes distintas7
Citas por año0,47
Intervalo de citas2011 - 2017 (7)
Velocidad de citaciónhistorical
Altamente citadoNo
Tipos de citaNeutras: 6
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