Graham Carrie, Ross Leslie, Bueno Edward Bozell, Harrington Charlene
1 Center for the Advanced Study of Aging Services, Berkeley, CA, USA.
2 University of California, San Francisco, USA.
Inquiry. 2018 Jan-Dec;55:46958018800090. doi: 10.1177/0046958018800090.
Little is known about the quality of nursing homes in managed care organizations (MCOs) networks. This study (1) described decision-making criteria for selecting nursing home networks and (2) compared selected quality indicators of network and nonnetwork nursing homes. The sample was 17 MCOs participating in a California demonstration that provided integrated long-term services and supports to dually eligible enrollees in 2017. The findings showed that the MCOs established a broad network of nursing homes, with only limited attention to using quality criteria. Network nursing homes (602) scored significantly lower on 6 selected quality measures than nonnetwork (117) nursing homes. Low registered nurse and total nurse staffing were strong predictors of network nursing homes controlling for facility characteristics. Managed care organizations should consider greater transparency about the quality of their nursing homes and use specific quality criteria to improve the quality of their networks.
对于管理式医疗组织（MCOs）网络中的养老院质量，人们了解甚少。本研究（1）描述了选择养老院网络的决策标准，（2）比较了网络内和网络外养老院选定的质量指标。样本为参与2017年加利福尼亚一项示范项目的17个MCOs，该项目为双重资格参保人提供综合长期服务和支持。研究结果表明，MCOs建立了广泛的养老院网络，但对使用质量标准的关注有限。在6项选定的质量指标上，网络内养老院（602家）的得分显著低于网络外养老院（117家）。在控制了机构特征后，注册护士和护士总人数较低是网络内养老院的有力预测指标。管理式医疗组织应考虑提高其养老院质量的透明度，并使用具体的质量标准来提升其网络质量。
