Variation Across US Assisted Living Facilities: Admissions, Resident Care Needs, and Staffing
Variation Across US Assisted Living Facilities: Admissions, Resident Care Needs, and Staffing
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DOI：
10.1111/jnu.12262
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发表时间：
2017-01-01
影响因子：
3.4
通讯作者：
Yang, Bo Kyum
中科院分区：
文献类型：
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作者：
Han, Kihye;Trinkoff, Alison M.;Yang, Bo Kyum
虽然在美国目前居住在辅助生活设施（ALFs）比疗养院，很少有人知道ALF的准入政策，居民的护理需求和人员配备的特点。因此，我们进行了这项研究，使用全国范围内的ALFs样本来检查这些因素，沿着比较ALFs的大小。设计横断面二级数据分析使用的数据从2010年全国调查的住宅护理设施。方法措施包括9个入院政策项目，7个项目的比例居民选定的条件或护理需求，和6个项目的工作人员的特点（例如，获得有执照的护士、助理培训）。设施（n = 2 301）按规模分为三类：小型，4至10张床位;中型，11至25张床位;大型，26张或更多床位。分析采取了复杂的抽样设计的影响，以项目国家美国的估计。FindingsMore的一半ALFs承认居民有相当大的医疗保健需求和服务的人口，需要护理，如转让，药物，饮食或穿衣。工作人员主要由病人护理助理组成，只有不到一半的ALF有执照的护理提供者（注册护士，执业护士）小时。较小的设施往往有更多的包容性入院政策和居民更复杂的护理需求（更多的流动性，饮食和药物援助，短期记忆问题，p <0.01）和更大的ALFs（p <0.01），更少的访问持牌护士比ALFs（p <0.01）。尽管有这一发现，ALF法规仍远远落后于疗养院的现行法规。此外，护理结果的测量是非常需要的，以确保适当的ALF护理quality.Clinical RelevanceAs更多的人选择ALF，ALF的结果措施，现在是不可用的，应制定允许监督和监测的护理质量。
PurposeThough more people in the United States currently reside in assisted living facilities (ALFs) than nursing homes, little is known about ALF admission policies, resident care needs, and staffing characteristics. We therefore conducted this study using a nationwide sample of ALFs to examine these factors, along with comparison of ALFs by size.DesignCross-sectional secondary data analysis using data from the 2010 National Survey of Residential Care Facilities.MethodsMeasures included nine admission policy items, seven items on the proportion of residents with selected conditions or care needs, and six items on staffing characteristics (e.g., access to licensed nurse, aide training). Facilities (n = 2,301) were divided into three categories by size: small, 4 to 10 beds; medium, 11 to 25 beds; and large, 26 or more beds. Analyses took complex sampling design effects into account to project national U.S. estimates.FindingsMore than half of ALFs admitted residents with considerable healthcare needs and served populations that required nursing care, such as for transfers, medications, and eating or dressing. Staffing was largely composed of patient care aides, and fewer than half of ALFs had licensed care provider (registered nurse, licensed practical nurse) hours. Smaller facilities tended to have more inclusive admission policies and residents with more complex care needs (more mobility, eating and medication assistance required, short-term memory issues, p < .01) and less access to licensed nurses than larger ALFs (p < .01).ConclusionsThis study suggests ALFs are caring for and admitting residents with considerable care needs, indicating potential overlap with nursing home populations. Despite this finding, ALF regulations lag far behind those in effect for nursing homes. In addition, measurement of care outcomes is critically needed to ensure appropriate ALF care quality.Clinical RelevanceAs more people choose ALFs, outcome measures for ALFs, which are now unavailable, should be developed to allow for oversight and monitoring of care quality.