To determine the agreement of measures of care in different settings—hospitals, nursing homes (s), and home health agencies (s)—and identify communities with high‐quality care in all settings.
Publicly available quality measures for hospitals, s, and s, linked to hospital service areas (s).
We constructed composite quality measures for hospitals, s, and nursing homes. We used these measures to identify s with exceptionally high‐ or low‐quality of care across all settings, or only high hospital quality, and compared these with respect to sociodemographic and health system factors.
We identified three dimensions of hospital quality, four dimensions, and two dimensions; these were poorly correlated across the three care settings. s that ranked high on all dimensions had more general practitioners per capita, and fewer specialists per capita, than s that ranked highly on only the hospital measures.
Higher quality hospital, , and care are not correlated at the regional level; regions where all dimensions of care are high differ systematically from regions which score well on only hospital measures and from those which score well on none.
Data Sources/Study Setting