de Cordova Pamela B, Johansen Mary L, Zha Peijia, Prado Joseph, Field Victoria, Cadmus Edna
Rutgers, The State University of New Jersey, Newark, NJ, USA; New Jersey Collaborating Center for Nursing, Newark, NJ, USA.
Rutgers, The State University of New Jersey, Newark, NJ, USA.
J Am Med Dir Assoc. 2021 Nov;22(11):2373-2377. doi: 10.1016/j.jamda.2021.03.011. Epub 2021 Apr 13.
Public reporting is a policy to improve quality and increase data transparency. The objective was to examine the association between publicly available staffing ratios and the Five-Star Quality Ratings from Nursing Home Compare over time.
Panel data analysis.
About 146 nursing homes with complete quarterly data in New Jersey between January 1, 2012, and December 31, 2019.
Using data from the State of New Jersey Department of Health and Nursing Home Compare, staff-to-resident ratios were trended for registered nurses, licensed practical nurses, and certified nursing assistants by shift and over time. Panel data analysis was used to test the association between the ratios and the ratings.
Compared to 2012, staffing ratios improved slightly for licensed practical nurses but not for registered nurses or certified nursing assistants in 2019 (P < .001). The number of residents assigned doubled at night for all personnel. During the day and evening shifts, registered nurse staffing was significantly associated with the Nursing Home Compare staffing rating (P < .01) but not the overall rating.
Decreasing the number of residents assigned to a registered nurse in NHs results in an increase in staffing ratings. Mandatory public reporting holds nursing homes accountable for quality outcomes but does not improve staffing ratios. Quality resident care is the cumulative result of multiple measures inclusive of staffing; therefore, administrators should continue to focus on improving quality in NHs, which may improve staffing ratios across shifts.
公开报告是一项旨在提高质量和增强数据透明度的政策。本研究旨在探讨随时间推移，公开可得的人员配备比率与养老院比较系统中的五星级质量评级之间的关联。
面板数据分析。
2012年1月1日至2019年12月31日期间，新泽西州约146家拥有完整季度数据的养老院。
利用新泽西州卫生部和养老院比较系统的数据，按班次和时间趋势分析注册护士、执业护士和认证护理助理的员工与居民比率。采用面板数据分析来检验这些比率与评级之间的关联。
与2012年相比，2019年执业护士的人员配备比率略有提高，但注册护士或认证护理助理的比率未提高（P <.001）。所有人员夜间分配的居民数量翻倍。在白班和晚班期间，注册护士的人员配备与养老院比较系统的人员配备评级显著相关（P <.01），但与总体评级无关。
养老院中分配给注册护士的居民数量减少会导致人员配备评级提高。强制性公开报告使养老院对质量结果负责，但并未提高人员配备比率。优质的居民护理是包括人员配备在内的多项措施的累积结果；因此，管理人员应继续专注于提高养老院的质量，这可能会改善各班次的人员配备比率。
