养老院的员工数量和居民特点在较大而不是较小的连锁店
Matthew P Maughan1, Jiani Yu1, Hye-Young Jung1
1Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
Journal of the American Medical Directors Association
|November 21, 2024
概括
较大的养老院连锁服务于不那么复杂的患者,但员工数量较低. 由于人员问题,建议加强对这些大型连锁店的监控.
科学领域:
- 老年学和卫生服务研究研究
- 医疗保健管理和政策
- 养老院运营和质量管理
背景情况:
- 养老院 (NH) 连锁店在规模和运营特点上有很大差异.
- 了解NH链的大小和设施/患者个人资料之间的关系对于政策制定至关重要.
- 之前的研究还没有完全阐明较小和较大的NH连锁之间在患者复杂性和人员配置方面的区别.
研究的目的:
- 分析与较小与较大的养老院连锁链相关的患者和设施特征.
- 检查养老院连锁规模与人员配置结果之间的关联.
主要方法:
- 采用来自LTCFocus 2021和CMS附属实体绩效指标 (2023年6月) 的全国代表性数据进行横截面研究设计.
- 分析包括美国610家连锁店的9348家NH.
- 使用单向ANOVA和线性回归来比较设施/患者特征,并评估跨NH链大小五分之一的人员配置结果.
主要成果:
- 较小的NH链表现出更高的阿尔茨海默氏症/痴呆症患者和需要ADL协助的长期住院居民的百分比.
- 较大的NH连锁店与总护理人员,RN,CNA和周末总护理人员的每日住院人员数量显著减少.
- 医疗保险和医疗补助服务中心 (CMS) 的员工评级在最大的NH链五分位数中也较低.
结论:
- 较大的养老院连锁店倾向于管理不那么临床复杂的患者群体,同时报告员工比例减少.
- 调查结果表明,决策者和监管机构需要加强对大型NH链的员工数量监测.
- 政策影响包括潜在的反断和监管审查,因为观察到的人员和患者资料的趋势.
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