Creating peer groups for assessing and comparing nursing home performance.

Background: Publicly reported performance data for hospitals and nursing homes are becoming ubiquitous. For such comparisons to be fair, facilities must be compared with their peers.

Objectives: To adapt a previously published methodology for developing hospital peer groupings so that it is applicable to nursing homes and to explore the characteristics of "nearest-neighbor" peer groupings.

Fatal falls among older construction workers.

Objective: This study examines recent trends and patterns in fall fatalities in the U.S. construction industry to determine whether fatal falls among older workers are different from younger workers in this industry.

Chronic diseases and functional limitations among older construction workers in the United States: a 10-year follow-up study.

Objectives: To examine the health status of older construction workers in the United States, and how occupation and the aging process affect health in workers' later years.

Methods: We analyzed six waves (1998 to 2008) of the Health and Retirement Study, a longitudinal survey of US residents age 50+. The study sample totaled 7200 male workers (510 in construction trades) in the baseline.

Relationship between clinical conditions and use of Veterans Affairs health care among Medicare-enrolled veterans.

Objective: To determine how reliance on Veterans Affairs (VA) for medical care among veterans enrolled in Medicare is affected by medical conditions, access, and patient characteristics.

Data Sources/study Setting: Department of Veterans Affairs.

Study Design: We examined reliance on the VA for inpatient, outpatient, and overall medical care among all VA users in fiscal years 2003 and 2004 who were also enrolled in Medicare.

Method to develop health care peer groups for quality and financial comparisons across hospitals.

Objective: To develop and explore the characteristics of a novel "nearest neighbor" methodology for creating peer groups for health care facilities.

Data Sources: Data were obtained from the Department of Veterans Affairs (VA) databases. STATISTICAL METHODS AND FINDINGS: Peer groups are developed by first calculating the multidimensional Euclidean distance between each of 133 VA medical centers based on 16 facility characteristics.

The effect of referral and transfer patients on hospital funding in a capitated health care delivery system.

Objectives: (1) To investigate whether inpatients referred or transferred between facilities result in increased financial loss compared with those admitted directly, in a health care delivery system funded by capitation methods. (2) To determine whether the higher cost of those patients transferred or referred is fairly compensated by a diagnosis-based risk adjustment system, and whether tertiary care facilities bear an unfair financial burden for such patients in a capitated financing environment.

Methods: The study cohort included all Veterans Affairs (VA) beneficiaries who received inpatient care during fiscal year (FY) 2004.

Does pay-for-performance improve the quality of health care?

Background: Most physicians and hospitals are paid the same regardless of the quality of the health care they provide. This produces no financial incentives and, in some cases, produces disincentives for quality. Increasing numbers of programs link payment to performance.