Case-mix and quality indicators in Chinese elder care homes: are there differences between government-owned and private-sector facilities?
Case-mix and quality indicators in Chinese elder care homes: are there differences between government-owned and private-sector facilities?
复制标题
DOI：
10.1111/jgs.12647
复制
发表时间：
2014-02
影响因子：
6.3
通讯作者：
Mor V
中科院分区：
文献类型：
--
作者：
Liu C;Feng Z;Mor V
评估中国老年护理设施的所有权与其绩效质量之间的关联;并比较政府所有和私营部门养老院的居民和设施特征的病例组合概况。横断面研究。南京（2009年）和天津（2010年）养老院普查。140家（占总数的95%）养老机构位于南京市区，157家（占总数的97%）养老机构位于天津市区。我们根据日常生活活动（ADL）限制和认知障碍创建了一个汇总病例组合指数，以衡量每个设施中居民的护理需求水平。我们选择了结构，过程和结果的措施，以评估设施水平的护理质量。我们还制定了一项结构性质量指标，即相对于居民的护理需求水平而言人员配备不足，这表明考虑到居民的病例组合，人员配备可能不足。政府拥有的住房有显着更高的入住率，大概反映了公众对公共补贴床位的需求，但他们服务的居民，平均而言，有较少的ADL和认知功能的限制比私营部门的设施。在一系列的结构，过程和结果的质量措施，没有明确的证据表明任何所有权类型的优点或缺点。然而，当工作人员与居民的比例是衡量相对于居民的病例组合，私营部门的设施更有可能比政府拥有的设施人手不足。在南京和天津，私营养老院更有可能人手不足，尽管它们的居民平均而言比政府机构的居民更虚弱。病例组合的差异可能是选择性入院政策的结果，这些政策有利于政府设施中相对健康的居民，而不是私营部门的居民。
To assess the association between ownership of Chinese elder care facilities and their performance quality; and to compare the case-mix profile of residents and facility characteristics in government-owned and private-sector homes. Cross-sectional study. Census of elder care homes surveyed in Nanjing (in 2009) and Tianjin (in 2010). 140 (or 95% of all) elder care facilities located in urban Nanjing, and 157 (or 97% of all) facilities in urban Tianjin. We created a summary case-mix index based on activities of daily living (ADL) limitations and cognitive impairment to measure levels of care needs among residents in each facility. We selected structure, process, and outcome measures to assess facility-level quality of care. We also developed a structural quality measure, under-staffing relative to residents’ levels of care needs, which indicates potentially inadequate staffing given the residents’ case-mix. Government-owned homes have significantly higher occupancy rates, presumably reflecting popular demand for publicly subsidized beds, but they serve residents who, on average, have fewer ADL and cognitive functioning limitations than do private-sector facilities. Across a range of structure, process, and outcome measures of quality, there is no clear evidence suggesting advantages or disadvantages to either ownership type. However, when staffing to resident ratio is gauged relative to residents’ case-mix, private-sector facilities were more likely to be under-staffed than government-owned facilities. In Nanjing and Tianjin, private-sector homes were more likely to be understaffed, although their residents were sicker and frailer, on average, than those in government facilities. The case-mix differences are likely the result of selective admission policies that favor relatively healthier residents in government facilities than in private-sector homes.
登录
查看更多内容
影响因子：
2.5
作者：
Liang, Z
通讯作者：
Liang, Z
影响因子：
105.7
作者：
Kerrison, SH;Pollock, AM
通讯作者：
Pollock, AM
影响因子：
5.4
作者：
Gu, Danan;Dupre, Matthew E.;Liu, Guangya
通讯作者：
Liu, Guangya
DOI：
10.2307/3348969
发表时间：
1966-01-01
期刊：
MILBANK MEMORIAL FUND QUARTERLY-HEALTH AND SOCIETY
影响因子：
--
作者：
DONABEDIAN, A
通讯作者：
DONABEDIAN, A
影响因子：
2.4
作者：
JIANG, L
通讯作者：
JIANG, L