Castle N G
Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ 08901, USA.
Gerontologist. 2001 Apr;41(2):161-72. doi: 10.1093/geront/41.2.161.
This study examined organizational and market factors associated with nursing homes that are most likely to be early adopters of innovations. Early adopter institutions, defined as the first 20% of facilities to adopt an innovation, are important because they subsequently facilitate the diffusion of innovations to others in the industry.
Two groups of innovations were examined, special care units and subacute care services. I used discrete-time logistic regression analysis and nationally representative data from 13,162 facilities at risk of being early adopters of innovations during twelve 6-month intervals from 1992 to 1997.
Organizational factors that increase the likelihood of early innovation adoption are larger bed size, chain membership, and high levels of private-pay residents. Four market factors that increase the likelihood of early innovation adoption are: a retrospective Medicaid reimbursement methodology, a more competitive environment, higher average income in the county, and a higher number of hospital beds in the county.
This analysis shows that organizational and market characteristics of nursing homes affect their propensity toward early adoption of innovations. Some of the results may be useful for nursing home administrators and policy makers attempting to promote innovation.
本研究考察了与最有可能成为创新早期采用者的养老院相关的组织和市场因素。早期采用机构被定义为最早采用某项创新的20%的机构，它们很重要，因为随后它们会促进创新在行业内传播给其他机构。
考察了两组创新，即特殊护理单元和亚急性护理服务。我使用离散时间逻辑回归分析以及1992年至1997年期间12个6个月间隔内来自13162个有成为创新早期采用者风险的机构的全国代表性数据。
增加早期采用创新可能性的组织因素包括更大的床位规模、连锁机构成员身份以及高比例的自费居民。增加早期采用创新可能性的四个市场因素是：追溯性医疗补助报销方法、竞争更激烈的环境、县内更高的平均收入以及县内更多的医院床位。
该分析表明养老院的组织和市场特征会影响其早期采用创新的倾向。部分结果可能对试图推动创新的养老院管理人员和政策制定者有用。
