医疗补助普查与养老院特征对居民心理社会护理质量的交互影响。
Interaction effect of Medicaid census and nursing home characteristics on quality of psychosocial care for residents.
机构信息
Center for Mental Health Policy and Services Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
出版信息
Health Care Manage Rev. 2011 Jan-Mar;36(1):47-57. doi: 10.1097/HMR.0b013e3181f8a864.
BACKGROUND
Numerous studies have identified disparities in nursing home quality of care. Although previous studies have found the overlap among Medicaid census, nursing home characteristics, and negative quality of care outcomes, few studies have examined how the psychosocial well-being of nursing home residents is associated with Medicaid census and other nursing home characteristics.
PURPOSE
The purpose of this study was to elucidate the intertwined relationships between Medicaid census and other important nursing home factors and its impact on psychosocial care for residents. This study examined the interactive effects of (1) nursing home ownership status and Medicaid census, (2) staffing level and Medicaid census, and (3) resident ethnic mix and Medicaid census on psychosocial well-being outcomes.
METHODOLOGY
The sample, derived from a combined data set of New York State nursing homes' Online Survey Certification and Reporting System and Minimum Data Set, included 565 nursing homes in rural and urban areas of the state.
FINDINGS
Medicaid census had no main effect on psychosocial well-being outcomes of nursing home care but had a significant interactive effect with other nursing home characteristics. High Medicaid census was associated with lower level of psychosocial symptom detection in nonprofit nursing homes and nursing homes with a higher proportion of ethnic minority residents.
PRACTICE IMPLICATIONS
Nursing staff training on better psychosocial well-being care, in particular, better psychosocial assessment, is important. To obtain the training resources, nursing homes with high Medicaid census can collaborate with other nursing homes or social service agencies. Considering that nursing homes with a high proportion of ethnic minority residents have lower level of detection rate for psychosocial well-being issues, culturally competent care should be a component of quality improvement plans.
背景
许多研究已经确定了养老院护理质量的差异。尽管先前的研究已经发现医疗补助普查、养老院特征和负面护理质量结果之间存在重叠，但很少有研究探讨养老院居民的心理社会福祉与医疗补助普查和其他养老院特征之间的关系。
目的
本研究旨在阐明医疗补助普查与其他重要养老院因素之间的复杂关系及其对居民心理社会护理的影响。本研究考察了（1）养老院所有权状况和医疗补助普查、（2）人员配备水平和医疗补助普查以及（3）居民族裔构成和医疗补助普查对心理社会福祉结果的交互影响。
方法
该样本来自纽约州养老院在线调查认证和报告系统和最低数据集的合并数据集，包括该州农村和城市地区的 565 家养老院。
发现
医疗补助普查对养老院护理的心理社会福祉结果没有主要影响，但与其他养老院特征有显著的交互作用。高医疗补助普查与非营利性养老院和少数民族居民比例较高的养老院中心理社会症状检测水平较低有关。
实践意义
对护理人员进行更好的心理社会福祉护理培训，特别是更好的心理社会评估，非常重要。为了获得培训资源，医疗补助普查较高的养老院可以与其他养老院或社会服务机构合作。考虑到少数民族居民比例较高的养老院对心理社会福祉问题的检测率较低，文化能力护理应该成为质量改进计划的一个组成部分。
Zotero 插件