Staffing characteristics and injury-related emergency department use among assisted living residents with Alzheimer's Disease and Related Dementias (ADRD)

项目摘要 受伤是老年人急诊室就诊的主要原因。阿尔茨海默氏症患者 疾病和相关痴呆（ADRD）尤其容易受伤，主要是由于福尔斯跌倒。较低水平的 直接护理人员与疗养院的受伤有关。目前还不知道关于 直接护理人员配备水平与辅助治疗中损伤相关急诊科（艾德）使用之间的关系 生活（AL）社区AL社区的80万人中约有40%患有ADRD。 虽然AL社区提供住房，个人护理，每天至少两餐，24小时监督， 此外，他们无须提供24小时护理服务。与养老院不同的是， 社区是在州一级而不是在联邦一级管理的。因此，直接护理人员的水平 国家之间和国家内部的政策也各不相同。该项目的目的是研究 直接护理人员配备水平和政策与AL居民中与伤害相关的艾德使用相关， ADRD。对于第一个目标，我们将研究AL直接护理人员配备水平是否与伤害有关- AL患者ADRD的相关艾德访视。具体来说，使用2007年至2019年的俄亥俄州的两年一度的调查， 与医疗保险索赔相关的长期护理设施，我们将检查 在俄亥俄州患有ADRD的AL居民中，直接护理人员配备水平和损伤相关的艾德使用。为 第二个目标是，利用州人事条例数据库，我们将研究州政策的变化 与最低直接护理人员配备水平相关的影响Medicare登记AL中损伤相关艾德使用 2007年至2019年期间患有ADRD的居民。该项目预计将改善对 居住在AL社区的ADRD居民。国家和AL社区可以使用获得的信息 从这项研究中了解与直接护理人员配备水平有关的政策和做法。

Project Summary Injuries are a leading cause of emergency department visits among older adults. Individuals with Alzheimer's disease and related dementias (ADRD) are at particular risk of injuries, primarily due to falls. Lower levels of direct care staffing are related to injuries in nursing homes. Currently, nothing is known regarding the relationship between direct care staffing levels and injury-related emergency department (ED) use in assisted living (AL) communities. Approximately 40% of the 800,000 individuals in AL communities have ADRD. Although AL communities provide housing, personal care, at least two meals a day, and oversight 24 hours a day, they are not required to provide round-the-clock nursing services. Also unlike nursing homes, AL communities are regulated at the state level rather than the federal level. As a result, direct care staffing levels and policies are variable among and within states. The goal of the proposed project is to examine whether direct care staffing levels and policies are associated with injury-related ED use among AL residents with ADRD. For the first aim, we will examine whether AL direct care staffing levels are associated with injury- related ED visits among AL residents with ADRD. Specifically, using 2007 to 2019 of Ohio's Biennial Survey of Long-Term Care Facilities linked to Medicare claims, we will examine the relationship between changes in direct care staffing levels and injury-related ED use among AL residents with ADRD in the state of Ohio. For the second aim, using a database of state staffing regulations, we will examine how states' changes in policies related to minimum direct care staffing levels affect injury-related ED use among Medicare-enrolled AL residents with ADRD between 2007 and 2019.The project is expected to improve the delivery of care to the residents who live in AL communities with ADRD. States and AL communities can use the information gained from this study to inform policies and practices related to direct care staffing levels.