Robert M. LaFollette School of Public Affairs, University of Wisconsin-Madison, Madison, WI, USA.
UCLA/VA Los Angeles Division of Geriatrics at UCLA Borun Center and VA GRECC, Los Angeles, CA, USA.
J Am Med Dir Assoc. 2022 Jul;23(7):1153-1158.e1. doi: 10.1016/j.jamda.2021.09.011. Epub 2021 Oct 9.
Within the context of a single study, assess the relative importance of the 6 factors identified in a 2019 systematic review as associated with the likelihood that family members will visit nursing home residents.
Retrospective statistical analysis of an existing survey data set.
A national survey conducted with 4350 relatives of long-term nursing home residents.
Probit models of the probability of visiting a family member at least once weekly, stratified by age of the visitor, were estimated. To account for possible endogeneity of respondent involvement in the choice of nursing home and visit rate, visit rates were estimated using 2-stage residual inclusion in which the first stage explained involvement in nursing home choice.
Involvement in nursing home choice has a substantively and statistically significant positive effect on visit probability for all age groups of respondents. Travel time has a substantively and statistically significant negative association on visit probability for all age groups. Younger women are more likely to visit than younger men. For all but the oldest respondents, higher income and full-time employment contribute to involvement in nursing home choice as does being Black or Hispanic.
As in previous research, travel time is an important determinant of visit rates. The strong association of involvement in nursing home choice with visit probability suggests a strong psychological motivation for visiting. To improve visiting, future research should focus on better understanding of the psychological factors that are associated with it and rely on better data and improved statistical methods. Our findings also suggest that nursing home administrators should consider adopting initiatives to facilitate and empower family members' involvement in nursing home choice, which in turn may lead to increased visitations.
在一项单一研究中,评估 2019 年系统评价中确定的与家庭成员探访长期护理院居民可能性相关的 6 个因素的相对重要性。
对现有调查数据集进行回顾性统计分析。
对 4350 名长期护理院居民的亲属进行了一项全国性调查。
对每个年龄段的探访者每周至少探访一次的概率进行了概率模型分析。为了说明受访者参与选择养老院和探访率的可能内生性,使用两阶段残差纳入法来估计探访率,其中第一阶段解释了参与养老院选择的情况。
参与养老院选择对所有年龄段的受访者的探访概率都有实质性和统计学上的积极影响。所有年龄段的受访者,旅行时间与探访概率呈实质性和统计学上的负相关。年轻女性比年轻男性更有可能探访。除了最年长的受访者外,较高的收入和全职工作以及黑人和西班牙裔身份有助于选择养老院。
与之前的研究一样,旅行时间是探访率的一个重要决定因素。参与养老院选择与探访概率之间的强关联表明探访存在强烈的心理动机。为了提高探访率,未来的研究应该集中于更好地理解与探访相关的心理因素,并依赖更好的数据和改进的统计方法。我们的研究结果还表明,养老院管理者应该考虑采取措施促进和授权家庭成员参与养老院选择,这反过来可能会增加探访次数。