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

项目摘要 伤害是老年人急诊科就诊的主要原因。阿尔茨海默氏症患者 疾病和相关痴呆症(ADRD)尤其有受伤的风险，主要是由于跌倒。较低水平的 直接护理人员配备与疗养院的伤害有关。目前，我们还不知道关于 受助者直接护理人员配备水平与伤害相关急诊科使用情况的关系 生活(AL)社区。在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、一天至少两餐，并一年24小时监督 当天，他们不需要提供全天候护理服务。与疗养院不同的是，AL 社区是在州一级而不是联邦一级进行管理的。因此，直接护理人员的配置水平 而且政策在各州之间和各州内部都是不同的。拟议项目的目标是检查是否 直接护理人员配备水平和政策与急性白血病住院患者使用与伤害相关的急救有关 阿德勒。对于第一个目标，我们将研究AL直接护理人员的水平是否与受伤有关- 急性白血病患者ADRD相关急诊就诊情况。具体地说，利用俄亥俄州2007至2019年的两年期调查 长期护理设施与联邦医疗保险索赔挂钩，我们将检查在 俄亥俄州患有ADRD的AL居民的直接护理人员配备水平和与伤害相关的急诊室使用情况。为 第二个目标，使用州人事法规的数据库，我们将检查各州在政策上的变化 与最低直接护理人员配备水平有关影响参加联邦医疗保险的AL中与伤害相关的急诊使用 2007年至2019年期间患有ADRD的居民。该项目预计将改善向 居住在AL社区的患有ADRD的居民。各州和AL社区可以利用获得的信息 从这项研究中了解与直接护理人员配备水平相关的政策和做法。

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.