Roberts Amy Restorick, Bowblis John R
Assistant professor of social work and research fellow, Scripps Gerontology Center, Miami University, McGuffey Hall, E. Spring Street, Oxford, OH, USA.
Associate professor of economics, Farmer School of Business, and research fellow, Scripps Gerontology Center, Miami University, Oxford, OH, USA.
Health Soc Work. 2017 Feb 1;42(1):15-23. doi: 10.1093/hsw/hlw058.
Although nurse staffing has been extensively studied within nursing homes (NHs), social services has received less attention. The study describes how social service departments are organized in NHs and examines the structural characteristics of NHs and other macro-focused contextual factors that explain differences in social service staffing patterns using longitudinal national data (Certification and Survey Provider Enhanced Reports, 2009-2012). NHs have three patterns of staffing for social services, using qualified social workers (QSWs); paraprofessional social service staff; and interprofessional teams, consisting of both QSWs and paraprofessionals. Although most NHs employ a QSW (89 percent), nearly half provide social services through interprofessional teams, and 11 percent rely exclusively on paraprofessionals. Along with state and federal regulations that depend on facility size, other contextual and structural factors within NHs also influence staffing. NHs most likely to hire QSWs are large facilities in urban areas within a health care complex, owned by nonprofit organizations, with more payer mixes associated with more profitable reimbursement. QSWs are least likely to be hired in small facilities in rural areas. The influence of policy in supporting the professionalization of social service staff and the need for QSWs with expertise in gerontology, especially in rural NHs, are discussed.
尽管在养老院（NHs）中护士人员配备已得到广泛研究，但社会服务受到的关注较少。该研究描述了养老院中社会服务部门是如何组织的，并利用全国纵向数据（认证与调查提供商强化报告，2009 - 2012年）研究了养老院的结构特征以及其他宏观背景因素，这些因素解释了社会服务人员配备模式的差异。养老院的社会服务有三种人员配备模式，分别是使用合格的社会工作者（QSWs）；辅助专业社会服务人员；以及由QSWs和辅助专业人员组成的跨专业团队。虽然大多数养老院雇佣了一名QSW（89%），但近一半的养老院通过跨专业团队提供社会服务，11%的养老院完全依赖辅助专业人员。除了取决于设施规模的州和联邦法规外，养老院内部的其他背景和结构因素也会影响人员配备。最有可能雇佣QSWs的养老院是位于医疗综合体内城市地区的大型设施，由非营利组织所有，有更多的付款人组合且报销利润更高。在农村地区的小型设施中雇佣QSWs的可能性最小。讨论了政策在支持社会服务人员专业化方面的影响以及对具有老年医学专业知识的QSWs的需求，特别是在农村养老院中的需求。
