所有权转换与养老院绩效。
Ownership conversions and nursing home performance.
作者信息
Grabowski David C, Stevenson David G
机构信息
Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115-5899, USA.
出版信息
Health Serv Res. 2008 Aug;43(4):1184-203. doi: 10.1111/j.1475-6773.2008.00841.x. Epub 2008 Mar 17.
OBJECTIVE
To examine the effects of ownership conversions on nursing home performance.
DATA SOURCE
Online Survey, Certification, and Reporting system data from 1993 to 2004, and the Minimum Data Set (MDS) facility reports from 1998 to 2004.
STUDY DESIGN
Regression specification incorporating facility fixed effects, with terms to identify trends in the pre- and postconversion periods.
PRINCIPAL FINDINGS
The annual rate of nursing home conversions almost tripled between 1994 and 2004. Our regression results indicate converting facilities are generally different throughout the pre/postconversion years, suggesting little causal effect of ownership conversions on nursing home performance. Before and after conversion, nursing homes converting from nonprofit to for-profit status generally exhibit deterioration in their performance, while nursing homes converting from for-profit to nonprofit status generally exhibit improvement.
CONCLUSIONS
Policy makers have expressed concern regarding the implications of ownership conversions for nursing home performance. Our results imply that regulators and policy makers should not only monitor the outcomes of nursing home conversions, but also the targets of these conversions.
目的
研究所有权转换对疗养院绩效的影响。
数据来源
1993年至2004年的在线调查、认证和报告系统数据，以及1998年至2004年的最低数据集（MDS）设施报告。
研究设计
纳入设施固定效应的回归规范，以及用于识别转换前后时期趋势的术语。
主要发现
1994年至2004年间，疗养院转换的年增长率几乎增长了两倍。我们的回归结果表明，在转换前后的年份里，进行转换的设施通常存在差异，这表明所有权转换对疗养院绩效几乎没有因果效应。在转换之前和之后，从非营利性转为营利性的疗养院通常绩效会恶化，而从营利性转为非营利性的疗养院通常绩效会改善。
结论
政策制定者对所有权转换对疗养院绩效的影响表示担忧。我们的结果表明，监管机构和政策制定者不仅应监测疗养院转换的结果，还应监测这些转换的目标。
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