Zhao Mei, Haley D Rob
Public Health Department, Brooks College of Health, University of North Florida, Jacksonville, Florida, USA.
J Health Care Finance. 2011 Fall;38(1):1-10.
Litigation activity against Florida's nursing home providers increased dramatically over the past two decades. This has been a significant concern for policy makers and nursing home administrators as they attempt to balance the realities of negligent behavior with its impact on the overall cost and quality of long-term care. This study uses Medicare Cost Report data and OSCAR (Online Survey, Certification, and Reporting) data for Florida's nursing facilities over a five-year period from 2001 to 2005 to examine the effect of quality and staffing on malpractice paid-losses. The results from the multiple regression analyses indicate that staffing levels are strongly associated with paid-losses for malpractice claims. Nursing homes with higher registered nurse to resident ratios are less likely to experience malpractice paid-losses. In contrast, higher nursing assistant to resident ratios are significantly related to higher probability of malpractice paid-losses. The effect of total deficiency on malpractice is not significant. These findings suggest that increases in more skilled nurse staffing are associated with lower likelihood of nursing home malpractice paid-losses. However, nursing homes need to balance the overall cost and quality of their facilities related to staffing and malpractice litigations.
在过去二十年中，针对佛罗里达州疗养院提供者的诉讼活动急剧增加。这一直是政策制定者和疗养院管理人员的重大关切，因为他们试图在疏忽行为的现实与其对长期护理的总体成本和质量的影响之间取得平衡。本研究使用2001年至2005年五年期间佛罗里达州护理机构的医疗保险成本报告数据和OSCAR（在线调查、认证和报告）数据，以检验质量和人员配置对医疗事故赔付损失的影响。多元回归分析的结果表明，人员配置水平与医疗事故索赔的赔付损失密切相关。注册护士与居民比例较高的疗养院发生医疗事故赔付损失的可能性较小。相比之下，护理助理与居民比例较高与医疗事故赔付损失的可能性显著相关。总缺陷对医疗事故的影响不显著。这些发现表明，增加技术更熟练的护士人员配置与疗养院医疗事故赔付损失的可能性降低有关。然而，疗养院需要在与人员配置和医疗事故诉讼相关的设施总体成本和质量之间取得平衡。
