Medical Staffing Organization and Quality of Care Outcomes in Post-acute Care Settings
Medical Staffing Organization and Quality of Care Outcomes in Post-acute Care Settings
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DOI：
10.1093/geront/gnaa173
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发表时间：
2021-06-01
期刊：
影响因子：
5.7
通讯作者：
Spetz, Joanne
中科院分区：
文献类型：
--
作者：
Wagner, Laura M.;Katz, Paul;Spetz, Joanne
背景和目的医疗服务提供者是显着的驱动程序，在急性期后长期护理（PALTC）的设置，但很少有研究探讨了医疗服务提供者的劳动力和它的作用，以确保quality of care.Research Design and Methods本研究探讨了影响护理之家医疗人员组织（NHMSO）的尺寸在美国护理之家的护理质量。主要数据来源是一项专门设计用于研究急性期后护理的医务人员组织的调查。受访者是提供PALTC的医疗主任和主治医生。我们将一些医疗服务提供者和疗养院的特征与医疗补助和医疗保险服务中心的疗养院比较质量指标，假设这些指标对医疗服务提供者的输入敏感。（n = 1，511），收到560份回复，回复率为37%; 425份医疗提供者回复包含足够的数据进行分析。NHMSO维度的影响结果是混合的，许多领域没有任何意义，或提供者的特征和质量措施之间存在负相关关系。受访者谁报告有一个正式的过程，授予特权和疗养院直接雇用的医生报告显着减少紧急visits.Discussion和影响进一步的研究是必要的，就什么样的质量措施是敏感的医疗提供者的特点和NHMSO的特点。
Background and Objectives Medical providers are significant drivers of care in post-acute long-term care (PALTC) settings, yet little research has examined the medical provider workforce and its role in ensuring quality of care.Research Design and Methods This study examined the impact of nursing home medical staffing organization (NHMSO) dimensions on the quality of care in U.S. nursing homes. The principal data source was a survey specifically designed to study medical staff organization for post-acute care. Respondents were medical directors and attending physicians providing PALTC. We linked a number of medical provider and nursing home characteristics to the Centers for Medicaid and Medicare Services Nursing Home Compare quality measures hypothesized to be sensitive to input by medical providers.Results From the sample of nursing home medical providers surveyed (n = 1,511), 560 responses were received, yielding a 37% response rate; 425 medical provider responses contained sufficient data for analysis. The results of the impact of NHMSO dimensions were mixed, with many domains not having any significance or having negative relationships between provider characteristics and quality measures. Respondents who reported having a formal process for granting privileges and nursing homes with direct employment of physicians reported significantly fewer emergency visits.Discussion and Implications Further research is needed regarding what quality measures are sensitive to both medical provider characteristics and NHMSO characteristics.