Nursing home control of physician resources

Area of Science:

• Gerontology
• Health Services Research
• Healthcare Management

Background:

• Physician services are crucial for nursing home (NH) quality of care.
• Limited understanding exists regarding how NHs manage physician resources.

Purpose of the Study:

• To measure the extent of NHs' control over physician resources.
• To develop and validate a scale for assessing NH Control of Physician Resources (NHCOPR).

Main Methods:

• Utilized national survey data from 1938 US NHs (2009-2010).
• Employed NH administrators' reports on policies for coordinating physician activities.
• Developed the NHCOPR scale (0=weakest, 3=tightest control) based on formal relationships, oversight, and credentialing.

Main Results:

• The average NHCOPR score was 1.58 (SD=0.77).
• NHs showed varied control: 30% weak, 47.5% average, 24.8% tight.
• NHCOPR demonstrated validity, correlating with NH size, Medicare services, and market physician density.

Conclusions:

• The NHCOPR scale effectively captures formal structures for managing physician resources in NHs.
• This scale can aid research on physician resource impact on resident outcomes.
• Findings support targeted interventions for NH administration regarding physician staff management.