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Using contingent valuation to develop consumer-based weights for health quality report cards

Objective: The current 5Star composite measure for nursing homes uses expertdriven weights to combine elements of quality into a single score. We assessed the feasibility of using the contingent valuation method (CVM) to derive consumers’ preferencebased weights for the Nursing Home Compare report card as a potential alternative approach.

Data Sources: Survey of 4310 adults with nursing home experience (residents or family members of a resident) administered between September 25 and October 9, 2017.

Study Design: Contingent valuation method based on respondents’ answers to questions about willingnesstotrade (WTT) visit travel time for better quality in seven quantitative indices included in Nursing Home Compare. We calculated WTT amounts per standard deviation change in quantitative indices to derive weights.

Data Collection Methods: Webbased survey.

Principal Findings: Contingent valuation method results are consistent with respondents making economically rational tradeoffs between quality and travel time. Estimates of mean WTT vary across quantitative quality indices. They also vary in terms of respondent status and behavioral factors. Weights based on mean WTT per standard deviation vary substantially across indices, with the largest weights for inspections and staffing.

Conclusions: Contingent valuation method has promise as a method for deriving weights for use in summary measures that incorporate consumer preferences.

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