Staffing and Health Outcomes in Nursing Homes for Residents with and without Dementia

疗养院中患有和未患有痴呆症的居民的人员配备和健康状况

• 批准号: 10621699
• 负责人: DANA B MUKAMEL
• 金额: $ 63.68万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10621699
• 关键词: Accounting; Address; Administrator; Advocate; Alzheimer' s Disease; Alzheimer' s disease related dementia; Area; Caring; Case Mixes; Certification; Data; Dementia; Development; Discipline of Nursing; Federal Government; Growth; Guidelines; Health; Home; Home Nursing Care; Industry; Knowledge; Language; Licensed Practical Nurse; Link; Marketing; Measures; Minority; National Institute on Aging; Nurses; Nursing Homes; Nursing Staff; Occupational; Occupational Therapist; Outcome; Outcome Measure; Pathologist; Patients; Policies; Policy Maker; Population; Prevalence; Publishing; Quality Indicator; Quality of Care; Registered nurse; Regulation; Reporting; Research; Social Work; Social Workers; Speech; Speech Therapist; Structure; Techniques; Testing; Translating; United States Centers for Medicare and Medicaid Services; Variant; Visit; cost; econometrics; improved; improved outcome; insight; nursing care quality; nursing standards; physical therapist; web app

PROJECT SUMMARY/ABSTRACT Nurse staffing – registered nurses, licensed practical nurses, and certified nurses’ assistants – have long been considered an important factor determining the quality of care that nursing home residents receive and their health outcomes. Information about nurse staffing levels are included in Nursing Home Compare (NHC), the report card published by the Centers for Medicare & Medicaid Services (CMS) as one of the three 5 Star sub-measures, as well as the overall 5-Star measure. Many states and the Federal Government have established minimum staffing standards for nursing homes. These attest to the importance that policy makers, experts, advocates, and residents place on staffing, as both determinants and indicators of quality. With the increasing prevalence of Alzheimer’s disease and related dementias (ADRD), nursing homes are facing an increasing population of residents with dementia (RWD). These residents are expected to require even higher staffing levels, compared with residents without ADRD. Yet, the information about, and our understanding of the needs for staffing other than nursing, such as therapists and social workers, and specifically how nurse staffing and other professional staff influence health outcomes for RWD is lacking. The objective of this proposal is 1) to address this gap in knowledge; and 2) to assess the impact of the projected increase in RWD in nursing homes on workforce requirements. This has been identified as an important policy objective, as indicated in the National Institute on Aging’s Research Milestone 13.J. The specific aims of the application are: 1) To apply econometric techniques to administrative data to estimate the effects of short- and long-term variations in nursing, therapy and social work staffing levels to several short- and long-term outcome measures for nursing homes treating a small percent and a large percent of RWD, and to assess the incremental staffing requirement by staff type and health outcome required in nursing homes with a high population of RWD compared with nursing homes with a low population of RWD; 2) To determine the implications of the findings for nursing homes and for local, state and national labor markets based on projected prevalence of RWD in nursing homes; and 3) To develop a web-based application for policy and decision makers based on our findings, which would allow them to test the impact of different ADRD and RWD growth scenarios and staffing standards policies on workforce predictions at the nursing home and market level.

项目摘要/摘要 护士人员配置--注册护士、执业护士和注册护士助理--长期以来 被认为是决定养老院居民接受和接受护理质量的重要因素 他们的健康状况。有关护士人员配置水平的信息包括在疗养院比较(NHC)中， 由医疗保险和医疗补助服务中心(CMS)作为三个五星之一发布的成绩单 子指标，以及整体五星指标。许多州和联邦政府都有 制定了养老院的最低人员配备标准。这些都证明了政策制定者， 专家、倡导者和居民都把人员配置作为质量的决定因素和指标。 随着阿尔茨海默病和相关痴呆症(ADRD)的流行，疗养院正在 面对日益增长的痴呆症(RWD)居民人口。这些居民预计将要求 与没有ADRD的居民相比，人员配备水平甚至更高。然而，关于我们的信息和我们的 了解护理以外的人员配置需求，如治疗师和社会工作者，以及 具体地说，护士人员配置和其他专业人员如何影响RWD的健康结果是缺乏的。这个 这项建议的目标是1)解决这一知识差距；和2)评估预测的 养老院对劳动力的需求增加了RWD。这已被确定为一项重要的政策 目标，正如国家老龄研究所的研究里程碑13.J. 应用程序的具体目标是：1)将计量经济技术应用于行政数据，以 估计护理、治疗和社会工作人员配备水平的短期和长期变化的影响 疗养院治疗小百分比和大百分比的几种短期和长期结果措施 RWD的百分比，并按工作人员类别和所需健康结果评估增加的人员需求 在RWD人口较多的养老院与RWD人口较低的养老院相比； 2)确定研究结果对养老院以及地方、州和全国劳工的影响 基于疗养院RWD预计患病率的市场；以及3)开发基于Web的应用程序 对于基于我们的发现的政策制定者和决策者，这将使他们能够测试不同 ADRD和RWD增长情景和人员编制标准关于护士劳动力预测的政策 国内和市场层面。