Nursing Home Chain Affiliation and Its Impact on Specialty Service Designation for Alzheimer Disease.
Nursing Home Chain Affiliation and Its Impact on Specialty Service Designation for Alzheimer Disease.
复制标题
DOI：
10.1177/0046958018787992
复制
发表时间：
2018-01
期刊：
影响因子：
--
通讯作者：
Banaszak-Holl J
中科院分区：
文献类型：
--
作者：
Blackburn J;Zheng Q;Grabowski DC;Hirth R;Intrator O;Stevenson DG;Banaszak-Holl J
20 世纪 90 年代，疗养院 (NH) 中的专科护理病房 (SCU) 越来越受欢迎，以吸引居民，同时国家政策和治疗模式也发生了变化。阿尔茨海默病一直是 SCU 的主要形式。本研究探讨了 NH 中常见的连锁隶属关系对 SCU 床位指定的影响程度。我们使用 1996 年至 2010 年在线调查认证和报告 (OSCAR) 的数据以及 207 431 个 NH 年观测数据，描述了趋势并将连锁附属 NH 与独立 NH 进行了比较。从 1996 年到 2003 年，阿尔茨海默病 SCU 的床位数量有所增加，然后有所下降。在高峰期，19.6% 的 NH 拥有至少一张阿尔茨海默病 SCU 床位。总体而言，连锁店隶属关系促进了阿尔茨海默病 SCU 床位在时间、连锁店规模和 NH 利润状况方面的指定。在 1996 年至 2003 年增长最快的时期，大型连锁机构下属的营利性 NH 中指定阿尔茨海默病 SCU 床位的可能性比独立的营利性 NH 高出 1.55 个百分点 (P < .001)，并且从 2004 年到 2010 年仍高出 1.28 个百分点。然而，连锁机构下属的 NH 中患痴呆症的居民比例通常低于独立的 NH 。 NH。例如，尽管隶属于大型连锁店的营利性 NH 拥有更多阿尔茨海默病 SCU 床位，但其痴呆症居民数量比独立 NH 少近 3% (P < .001)。我们的结论是，为阿尔茨海默病 SCU 指定床位的组织决策可能与吸引居民的营销策略有关，因为阿尔茨海默病 SCU 的采用率随着时间的推移而波动，但似乎并非由需求驱动。
Specialty care units (SCUs) in nursing homes (NHs) grew in popularity during the 1990s to attract residents while national policies and treatment paradigms changed. Alzheimer disease has consistently been the dominant form of SCU. This study explored the extent to which chain affiliation, which is common among NHs, affected SCU bed designation. Using data from the Online Survey Certification and Reporting (OSCAR) from 1996 through 2010 with 207 431 NH-year observations, we described trends and compared chain-affiliated NHs with independent NHs. Designation of beds for Alzheimer disease SCUs grew from 1996 to 2003 and then declined. At the peak, 19.6% of all NHs had at least one Alzheimer disease SCU bed. In general, chain affiliation promoted Alzheimer disease SCU bed designation across time, chain size, and NH profit status. During the period of largest growth from 1996 to 2003, the likelihood of designation of Alzheimer disease SCU beds was 1.55 percentage points higher among for-profit NHs affiliated with large chains than independent for-profit NHs (P < .001) and remained 1.28 percentage points higher from 2004 to 2010. However, chain-affiliated NHs generally had a lower percentage of residents with dementia than independent NHs. For example, although for-profit NHs affiliated with large chains had more Alzheimer disease SCU beds, they had nearly 3% fewer residents with dementia than independent NHs (P < .001). We conclude that organizational decisions to designate beds for Alzheimer disease SCUs may be related to marketing strategies to attract residents since adoption of Alzheimer disease SCUs has fluctuated over time, but did not appear driven by demand.
登录
查看更多内容
影响因子：
12.7
作者：
Harrington, C;Woolhandler, S;Himmelstein, DU
通讯作者：
Himmelstein, DU
影响因子：
2.1
作者：
Castle, Nicholas G.
通讯作者：
Castle, Nicholas G.
影响因子：
2.8
作者：
Davis, Jullet A.;Marino, Louis D.;Tolbert, Carl L.
通讯作者：
Tolbert, Carl L.
影响因子：
2.8
作者：
Gruneir, Andrea;Lapane, Kate L.;Mor, Vincent
通讯作者：
Mor, Vincent
影响因子：
3
作者：
O'Neill, C;Harrington, C;Saliba, D
通讯作者：
Saliba, D