Castle N G
Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ, USA.
Gerontologist. 2001 Dec;41(6):757-67. doi: 10.1093/geront/41.6.757.
In this article, I examine the association between turnover of nursing home administrators and five important quality of care outcomes.
The data came from a survey of 420 nursing facilities and the 1999 On-line Survey, Certification, and Reporting System. Using multivariate logistic regression analyses, I looked at the effects of turnover of administrators in nursing homes belonging to chain organizations and in nursing homes not belonging to chain organizations.
I found the average annual turnover rate of administrators to be 43%. The multivariate logistic regression analyses show that in nursing homes belonging to chains, administrator turnover is associated with a higher than average proportion of residents who were catheterized, had pressure ulcers, and were given psychoactive drugs and with a higher than average number of quality-of-care deficiencies. In nursing homes not belonging to chains I found that turnover of administrators is associated with a higher than average proportion of residents who were restrained, were catheterized, had pressure ulcers, and were given psychoactive drugs.
There is a need to improve understanding of how and why better outcomes are achieved in some nursing homes. This investigation serves to focus attention on nursing home administrators. I believe this study provides preliminary evidence that the turnover of administrators may have an important association with quality of care in nursing homes.
在本文中，我探讨了养老院管理人员更替与五个重要护理质量结果之间的关联。
数据来自对420家护理机构的调查以及1999年的在线调查、认证和报告系统。通过多元逻辑回归分析，我研究了连锁组织所属养老院和非连锁组织所属养老院管理人员更替的影响。
我发现管理人员的年平均更替率为43%。多元逻辑回归分析表明，在连锁养老院中，管理人员更替与导尿、患有压疮、使用精神活性药物的居民比例高于平均水平以及护理质量缺陷数量高于平均水平有关。在非连锁养老院中，我发现管理人员更替与被约束、导尿、患有压疮、使用精神活性药物的居民比例高于平均水平有关。
有必要更好地理解一些养老院如何以及为何能取得更好的结果。这项调查旨在将注意力集中在养老院管理人员身上。我认为这项研究提供了初步证据，表明管理人员的更替可能与养老院的护理质量有重要关联。
