Harrington C, Zimmerman D, Karon S L, Robinson J, Beutel P
Department of Social and Behavioral Sciences, University of California, San Francisco 94118, USA.
J Gerontol B Psychol Sci Soc Sci. 2000 Sep;55(5):S278-87. doi: 10.1093/geronb/55.5.s278.
The authors examined the relationships between different types of nursing home staffing and nursing home deficiencies to test the hypothesis that fewer staff hours would be associated with higher numbers of deficiencies.
Data were from the On-Line Survey, Certification, and Reporting System for all certified nursing homes in the United States. Regression models examined total deficiencies, quality of care, quality of life, and other deficiencies.
Fewer registered nurse hours and nursing assistant hours were associated with total deficiencies and quality of care deficiencies, when other variables were controlled. Fewer nursing assistant staff and other care staff hours were associated with quality of life deficiencies. Fewer administrative staff hours were associated with other deficiencies. Facilities that had more depressed and demented residents, that were smaller, and that were nonprofit or government-owned had fewer deficiencies. Facilities with more residents with urinary incontinence and pressure sores and with higher percentages of Medicaid residents had more deficiencies, when staffing and resident characteristics were controlled.
Facility characteristics and states were stronger predictors of deficiencies than were staffing hours and resident characteristics. Because only a small portion of the total variance in deficiencies could be explained, much work remains to explore factors that influence deficiencies.
作者研究了不同类型的养老院工作人员配备与养老院缺陷之间的关系，以检验工作人员工作时长减少会导致缺陷数量增加这一假设。
数据来自美国所有经认证的养老院的在线调查、认证和报告系统。回归模型研究了总缺陷、护理质量、生活质量和其他缺陷。
在控制其他变量的情况下，注册护士工作时长和护理助理工作时长减少与总缺陷及护理质量缺陷相关。护理助理人员数量减少和其他护理人员工作时长减少与生活质量缺陷相关。行政人员工作时长减少与其他缺陷相关。有更多抑郁和痴呆居民、规模较小、非营利性或政府所有的养老院缺陷较少。在控制人员配备和居民特征的情况下，有更多尿失禁和压疮居民以及医疗补助居民比例较高的养老院缺陷较多。
与人员工作时长和居民特征相比，养老院特征和州是缺陷的更强预测因素。由于缺陷总方差中只有一小部分可以得到解释，因此仍有许多工作要做，以探索影响缺陷的因素。
