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

项目总结/摘要 护士人员配置-注册护士，执业护士和认证护士助理-长期以来， 被认为是决定护理质量的重要因素，养老院居民接受， 他们的健康结果。有关护士人员配备水平的信息包括在护理之家比较（NHC）， 医疗保险和医疗补助服务中心（CMS）公布的三个5星星之一的报告卡 子措施，以及整体5-星星措施。许多州和联邦政府已经 为养老院制定了最低人员配备标准。这些都证明了决策者， 专家、倡导者和住院医师对人员配置的重视，既是质量的决定因素，也是质量的指标。 随着阿尔茨海默病和相关痴呆症（ADRD）的日益流行，疗养院 面临着越来越多的痴呆症居民（RWD）。预计这些居民将需要 甚至更高的人员配备水平，与没有ADRD的居民相比。然而，关于我们的信息， 了解护理以外的人员配备需求，如治疗师和社会工作者，以及 特别是缺乏护理人员和其他专业人员如何影响RWD的健康结果。的 本提案的目标是：（1）弥补这一知识差距;（2）评估计划的影响。 养老院劳动力需求增加。这已被确定为一项重要政策 目标，如国家老龄化研究所的研究里程碑13所示。 应用的具体目标是：1）将计量经济学技术应用于行政数据， 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， 几个短期和长期的结果措施，为疗养院治疗一小部分和一大部分， 的百分比，并按工作人员类型和所需的健康结果评估增加的工作人员需求 与RWD人群较少的养老院相比，RWD人群较多的养老院; 2)确定研究结果对养老院以及地方、州和国家劳动力的影响 市场的基础上预计患病率RWD在疗养院和3）开发一个基于网络的应用程序 政策和决策者根据我们的研究结果，这将使他们能够测试不同的影响， ADRD和RWD增长情景以及护理人员劳动力预测的人员配备标准政策 国内和市场层面。

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.