Determinants of financial performance of home-visit nursing agencies in Japan.
Determinants of financial performance of home-visit nursing agencies in Japan.
复制标题
DOI：
10.1186/1472-6963-14-11
复制
发表时间：
2014-01-09
影响因子：
2.8
通讯作者：
Ikezaki S
中科院分区：
文献类型：
--
作者：
Fukui S;Yoshiuchi K;Fujita J;Ikezaki S
日本是世界上老龄化人口最多的国家，促进家庭保健服务是一个紧迫的政策问题。由于家访护理在家庭保健服务中起着重要作用，日本政府于1994年开始推广这一活动。然而，家访护理机构的规模仍然很小（2011年护理人员和其他人员的平均人数分别为4.2人和1.7人），财务业绩（盈利能力）是这类小型机构关注的问题。此外，与日本家访护理机构盈利能力相关的因素尚未得到多边和详细的审查。因此，本研究的目的是探讨家访护理机构财务绩效的决定因素。我们在日本进行了一项全国性的调查，随机选择了2912家家访护理机构。基于机构管理相关变量（运营结构、护士经理管理、就业、患者利用、质量控制、区域合作和财务状况），使用多项逻辑回归来澄清机构盈利能力（盈利、稳定或不盈利）的决定因素。在选取的家访护理机构中，有1340份回复适合分析，有效回复率为46.0%。多项逻辑回归分析表明，与财务业绩稳定的代理机构相比，代理机构的盈利能力和不盈利能力都与管理中的多个变量相关。这些变量包括护理人员/康复人员/患者的数量、所属医院、合作医院的数量、晚期患者的家庭死亡率、护士管理人员控制员工目标以及用于补偿的收入。研究结果表明，家访护理机构的经营结构、区域合作、人员雇用、病人利用和护理质量控制等管理变量对营利性和非营利性机构都有影响。这些研究结果表明，在日本家访护理机构实现稳定的财务绩效中，考虑管理问题的重要性。这一发现可能对其他人口老龄化日益严重的国家也有帮助。
Japan has the highest aging population in the world and promotion of home health services is an urgent policy issue. As home-visit nursing plays a major role in home health services, the Japanese government began promotion of this activity in 1994. However, the scale of home-visit nursing agencies has remained small (the average numbers of nursing staff and other staff were 4.2 and 1.7, respectively, in 2011) and financial performance (profitability) is a concern in such small agencies. Additionally, the factors related to profitability in home-visit nursing agencies in Japan have not been examined multilaterally and in detail. Therefore, the purpose of the study was to examine the determinants of financial performance of home-visit nursing agencies. We performed a nationwide survey of 2,912 randomly selected home-visit nursing agencies in Japan. Multinomial logistic regression was used to clarify the determinants of profitability of the agency (profitable, stable or unprofitable) based on variables related to management of the agency (operating structure, management by a nurse manager, employment, patient utilization, quality control, regional cooperation, and financial condition). Among the selected home-visit nursing agencies, responses suitable for analysis were obtained from 1,340 (effective response rate, 46.0%). Multinomial logistic regression analysis showed that both profitability and unprofitability were related to multiple variables in management of the agency when compared to agencies with stable financial performance. These variables included the number of nursing staff/rehabilitation staff/patients, being owned by a hospital, the number of cooperative hospitals, home-death rate among terminal patients, controlling staff objectives by nurse managers, and income going to compensation. The results suggest that many variables in management of a home-visit nursing agency, including the operating structure of the agency, regional cooperation, staff employment, patient utilization, and quality control of care, have an influence in both profitable and unprofitable agencies. These findings indicate the importance of consideration of management issues in achieving stable financial performance in home-visit nursing agencies in Japan. The findings may also be useful in other countries with growing aging populations.
影响因子：
1.7
作者：
Naruse, Takashi;Taguchi, Atsuko;Murashima, Sachiyo
通讯作者：
Murashima, Sachiyo
影响因子：
4.1
作者：
Kashiwagi M;Tamiya N;Sato M;Yano E
通讯作者：
Yano E