The influence of staffing characteristics on quality of care in nursing homes
The influence of staffing characteristics on quality of care in nursing homes
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DOI：
10.1111/j.1475-6773.2007.00704.x
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发表时间：
2007-10-01
影响因子：
3.4
通讯作者：
Engberg, John
中科院分区：
文献类型：
--
作者：
Castle, Nicholas G.;Engberg, John
目的探讨养老院人员配置水平、人员流失率、员工稳定性和机构员工对护理服务质量的影响。护士助理、执业护士和注册护士的人员配置特征被收集。14项质量指标来自疗养院比较网站成绩单，养老院组织特征来自在线调查、认证和记录系统。研究设计采用探索性因子分析将14项质量指标组合在一起，形成1个质量指标(结果)。除了对14个质量指标进行单独分析外，我们还使用回归分析来评估三类护理人员的四个人员特征对这一质量指数的影响。审查了组织特征及其运作所在的市场对结果的影响。我们检查了一些不同的模型规范。主要发现，护理质量在某种程度上受到所有这些人员特征的影响。然而，估计的交互效应表明，实现更高的质量依赖于拥有不止一个有利的人员特征-质量的影响大于每个有利人员特征的独立影响的总和。结论我们的结果表明，为了提高养老院的质量，应该同时考虑人员流动、人员水平、员工稳定性和机构人员等人员特征。
Objective The influence staffing levels, turnover, worker stability, and agency staff had on quality of care in nursing homes was examined.Data Sources/Study Setting Staffing characteristics came from a survey of nursing homes (N=1,071) Data conducted in 2003. The staffing characteristics were collected for Nurse Aides, Licensed Practical Nurses, and Registered Nurses. Fourteen quality indicators came from the Nursing Home Compare website report card and nursing home organizational characteristics came from the Online Survey, Certification, and Recording system.Study Design One index of quality (the outcome) was created by combining the 14 quality indicators using exploratory factor analysis. We used regression analyses to assess the effect of the four staffing characteristics for each of the three types of nursing staff on this quality index in addition to individual analyses for each of the 14 quality indicators. The effect of organizational characteristics as well as the markets in which they operated on outcomes was examined. We examined a number of different model specifications.Principal Findings Quality of care was influenced, to some degree, by all of these staffing characteristics. However, the estimated interaction effects indicated that achieving higher quality was dependent on having more than one favorable staffing characteristic-the effect of quality was larger than the sum of the independent effects of each favorable staffing characteristic.Conclusions Our results indicate that staff characteristics such as turnover, staffing levels, worker stability, and agency staff should be addressed simultaneously to improve the quality of nursing homes.