School of Social Work, University of Texas at Arlington, Arlington, TX, USA.
Leonard Davis School of Gerontology, University of Southern California, Los Angeles CA, USA.
Gerontologist. 2021 Aug 13;61(6):858-869. doi: 10.1093/geront/gnab035.
The purpose of this project was to examine individual-level ethnic and racial differences and facility-level differences in types of complaints and rates of complaint resolution in a local long-term care ombudsman program.
We employed a mixed-methods sequential explanatory design. First, we analyzed secondary complaint data based on residents' race and ethnicity (n = 464) and facility characteristics (n = 101). We then conducted 2 focus groups with ombudsmen (n = 12) to provide context for our quantitative findings and to explore the ombudsmen's views on disparities in long-term care facilities.
Racial and ethnic minority residents were more likely to generate complaints related to residents' rights than nonminority residents. Assisted living facilities were more likely to have complaints related to residents' rights and outside agencies than nursing homes. The rate of complaint resolution increased among facilities with a higher proportion of minority residents, compared to facilities with a lower proportion of minority residents. However, an estimation of cross-level interaction revealed that non-Hispanic White residents in these facilities experienced faster complaint resolution than minority residents. Ombudsmen expressed concerns about communication barriers between minority residents and facility staff and discussed different complaint types and resolution rates according to facility types.
Our findings highlight disparities across long-term care facilities as well as disparities in care minority residents experience. Long-term care ombudsman program complaint data should be disaggregated by race and ethnicity of the residents to advocate for policy change at facility, state, and federal levels.
本研究旨在考察某地方长期护理监察员计划中，个人层面的族裔和种族差异以及机构层面的投诉类型差异和投诉解决率差异。
我们采用混合方法顺序解释设计。首先，我们分析了基于居民种族和族裔（n=464）和机构特征（n=101）的二级投诉数据。然后，我们与监察员进行了2 次焦点小组讨论（n=12），为我们的定量研究结果提供背景，并探讨监察员对长期护理机构中差异的看法。
少数族裔居民比非少数族裔居民更有可能提出与居民权利相关的投诉。与养老院相比，辅助生活设施更有可能出现与居民权利和外部机构相关的投诉。与少数族裔居民比例较低的机构相比，少数族裔居民比例较高的机构的投诉解决率有所提高。然而，跨层次交互的估计表明，这些设施中的非西班牙裔白人居民的投诉解决速度快于少数民族居民。监察员对少数民族居民与机构工作人员之间的沟通障碍表示担忧，并根据机构类型讨论了不同的投诉类型和解决率。
我们的研究结果突出了长期护理机构之间的差异，以及少数民族居民所经历的护理差异。长期护理监察员计划的投诉数据应按居民的种族和族裔进行细分，以便在设施、州和联邦各级倡导政策变革。
