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Resultados de los hogares de ancianos después del programa CareGivers NC: una evaluación plurianual del personal y el
Swati S Jha1, Redwan Bin Abdul Baten1, Trent J Spaulding2
1Department of Health Policy and Management, University of North Carolina Charlotte, Charlotte, NC, USA.
Resumen
El programa CareGivers NC de Carolina del Norte, destinado a abordar la escasez de personal de hogares de ancianos, no mejoró las horas de personal ni los resultados de calidad. Se necesitan reformas integradas más allá de las estrategias de fuerza laboral.
Área de la Ciencia:
- Gestión de la Gestión de la Atención Médica.
- Gerontología Gerontología.
- Política de salud pública Política de salud pública.
Sus antecedentes:
- Los hogares de ancianos se enfrentan a una crisis crítica de mano de obra, en particular los asistentes de enfermería certificados (CNA).
- Las iniciativas a nivel estatal como el programa CareGivers NC de Carolina del Norte tienen como objetivo aliviar estas escaseces.
- La efectividad de tales intervenciones centradas en la fuerza de trabajo en los resultados de calidad sigue siendo subevaluada.
Objetivo del estudio:
- Evaluar el impacto del programa CareGivers NC en los niveles de personal e indicadores de calidad en los hogares de ancianos de Carolina del Norte.
- Determinar si la participación en una iniciativa de CNA liderada por el estado conduce a mejoras mensurables en el rendimiento de los hogares de ancianos.
Principales métodos:
- Utilizó un análisis de diferencias en diferencias combinado con el emparejamiento de puntajes de propensión.
- Datos de rendimiento analizados desde 2019 hasta el segundo trimestre de 2024 para hogares de ancianos participantes y no participantes.
- Examinó los cambios en el total, el empleado y las horas de CNA contratadas, junto con las calificaciones de calidad de los Centros de Servicios de Medicare y Medicaid (CMS).
Principales resultados:
- Los participantes del programa experimentaron una disminución significativa en el total y las horas de CNA de los empleados.
- Se observó un aumento marginal en las horas de CNA contratadas entre los participantes.
- No se encontraron mejoras consistentes en las calificaciones de calidad de CMS; las calificaciones de personal y medidas de calidad disminuyeron significativamente.
Conclusiones:
- Las intervenciones solo para la fuerza laboral como CareGivers NC demuestran una eficacia limitada en la mejora de la calidad de los hogares de ancianos.
- Las reformas integradas son esenciales, combinando las estrategias de personal con el liderazgo, la política y las consideraciones ambientales.
- Abordar la discriminación por edad en el sector de la salud es crucial para soluciones sostenibles para la fuerza laboral.
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