Do Nursing Home Chain Size and Proprietary Status Affect Experiences With Care?
Do Nursing Home Chain Size and Proprietary Status Affect Experiences With Care?
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DOI：
10.1097/mlr.0000000000000479
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发表时间：
2016-03
期刊：
影响因子：
3
通讯作者：
Banaszak-Holl J
中科院分区：
文献类型：
--
作者：
You K;Li Y;Intrator O;Stevenson D;Hirth R;Grabowski D;Banaszak-Holl J
2012年，超过一半的养老院由企业连锁经营。据报告，最大的营利性连锁店拥有的设施的护理质量较低。然而，目前尚不清楚如何护理之家连锁企业与护理经验。探讨护理之家连锁性质（连锁规模、营利状况）与病患家属对护理体验评价之关系。使用马里兰州疗养院护理经验报告、在线调查、认证和报告（OSCAR）文件和区域资源文件。我们的样本包括2007年至2010年马里兰州所有非政府疗养院。报告了消费者对以下方面的评分：总体护理;设施建议;工作人员业绩;提供的护理;食品和膳食;物质环境;自主权和个人权利。我们从OSCAR中确定了连锁特征，并估计了多变量随机效应线性模型，以检验连锁所有权对护理体验评级的影响。独立非营利养老院的总体评分最高，为8.9分，其次是小型非营利连锁机构的8.6分，独立营利机构的8.5分。小型、中型和大型营利性连锁店的设施总体评分更低，分别为8.2、7.9和8.0。我们发现，在推荐率以及工作人员沟通和护理质量等重要领域，存在类似的差异模式。有证据表明，马里兰州养老院隶属于大型和中型营利性连锁店有较低的评级家庭报告的经验与照顾。
In 2012, over half of nursing homes were operated by corporate chains. Facilities owned by the largest for-profit chains were reported to have lower quality of care. However, it is unknown how nursing home chain ownerships are related with experiences of care. To study the relationship between nursing home chain characteristics (chain size and profit status) with patients' family member reported ratings on experiences with care. Maryland nursing home care experience reports, the Online Survey, Certification, And Reporting (OSCAR) files, and Area Resource Files are used. Our sample consists of all non-governmental nursing homes in Maryland from 2007 to 2010. Consumer ratings were reported for: overall care; recommendation of the facility; staff performance; care provided; food and meals; physical environment; and autonomy and personal rights. We identified chain characteristics from OSCAR, and estimated multivariate random effect linear models to test the effects of chain ownership on care experience ratings. Independent nonprofit nursing homes have the highest overall rating score of 8.9, followed by 8.6 for facilities in small nonprofit chains, and 8.5 for independent for-profit facilities. Facilities in small, medium and large for-profit chains have even lower overall ratings of 8.2, 7.9, and 8.0, respectively. We find similar patterns of differences in terms of recommendation rate, and important areas such as staff communication and quality of care. Evidence suggests that Maryland nursing homes affiliated with large- and medium- for-profit chains had lower ratings of family reported experience with care.