美国养老院种族/民族多样性的背景决定因素。

Contextual determinants of US nursing home racial/ethnic diversity.

机构信息

Management Department, The University of Alabama, Box 870225, Tuscaloosa, AL 35487, USA; Center for Mental Health and Aging, The University of Alabama, Box 870315, Tuscaloosa, AL 35487, USA.

Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, 1530 Third Avenue South, Birmingham, AL 35294, USA.

出版信息

Soc Sci Med. 2014 Mar;104:142-7. doi: 10.1016/j.socscimed.2013.12.009. Epub 2013 Dec 21.

DOI:10.1016/j.socscimed.2013.12.009

PMID:24581072

Abstract

We hypothesized that for-profit/chain affiliated nursing homes, those in states with higher Medicaid reimbursement, and those in more competitive markets would have greater resident racial/ethnic diversity than nursing homes not meeting these criteria. Using 2004 Online Survey, Certification and Reporting data, Minimum Data Set, Lewis Mumford Center for Comparative Urban and Regional Research data, and the Area Resource File, we included U.S. Medicare/Medicaid certified nursing homes (N = 8950) located in 310 Metropolitan Statistical Areas. The dependent variable quantified facility-level multiracial diversity. Ordinary least squares regression showed support for the hypothesized relationships: for-profit/chain affiliated nursing homes were more diverse than nursing homes in all other ownership/chain member categories, while higher Medicaid per-diem rates, greater residential diversity, and stronger market competition were also positively associated with nursing home racial/ethnic composition. Results suggest there is room for policy changes to achieve equitable access to all levels of nursing home services for minority elders.

摘要

我们假设营利性/连锁附属养老院、那些在医疗补助报销较高的州以及那些在竞争更激烈的市场中的养老院，其居民的种族/民族多样性将高于不符合这些标准的养老院。利用 2004 年在线调查、认证和报告数据、最小数据集、刘易斯·芒福德比较城市和区域研究中心数据以及区域资源文件，我们包括了美国医疗保险/医疗补助认证的养老院（N=8950），这些养老院位于 310 个大都市统计区。因变量量化了设施层面的多种族多样性。普通最小二乘法回归显示，假设的关系得到了支持：营利性/连锁附属养老院比其他所有所有权/连锁成员类别的养老院更加多样化，而较高的医疗补助每日费用、更大的居住多样性和更强的市场竞争也与养老院的种族/民族构成呈正相关。研究结果表明，有政策调整的空间，可以实现少数民族老年人公平获得各级养老院服务的目标。