Graduate Research Assistant, Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA.
Project Support Coordinator, Center for Healthy Aging and Innovation, Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA.
J Aging Soc Policy. 2022 Sep 3;34(5):769-787. doi: 10.1080/08959420.2022.2083882. Epub 2022 Jul 3.
The federal Preadmission Screening and Resident Review (PASRR) program was enacted in the 1980s amid concerns surrounding the quality of nursing home (NH) care. This program is meant to serve as a tool to assist with level of care determinations for NH applicants with serious mental illness (SMI) and was intended to limit the growth in the number of NH residents with SMI. Despite this policy effort, the prevalence of SMI in NHs has continued to increase, and little is known about the mechanisms driving the heterogeneous and suboptimal administration of the PASRR program, absent routine evaluative efforts. We conducted 20 semi-structured interviews with state and national stakeholders to identify factors affecting PASRR program administration and NH care for residents with SMI. Stakeholders expressed concern regarding fragmentation, specifically lack of clarity in the value of assessments beyond a regulatory requirement. Additionally, they cited variable program administration as contributing to fragmented communication patterns and inconsistent training across jurisdictions. Given the number of people with SMI currently residing in NHs, policy and practice should take a person-centered approach to assess how PASRR can be better used to support resident needs.
联邦住院前筛查和居民审查（PASRR）计划于 20 世纪 80 年代制定，当时人们对养老院（NH）护理质量感到担忧。该计划旨在作为一种工具，协助确定有严重精神疾病（SMI）的 NH 申请人的护理水平，并旨在限制 NH 中 SMI 居民人数的增长。尽管有这项政策努力，但 NH 中 SMI 的患病率仍在继续增加，而且在没有常规评估工作的情况下，人们对推动 PASRR 计划管理和 NH 为 SMI 居民提供护理的异质和次优管理机制知之甚少。我们对州和国家利益相关者进行了 20 次半结构化访谈，以确定影响 PASRR 计划管理和 NH 为 SMI 居民提供护理的因素。利益相关者对碎片化表示关注，特别是对超出监管要求的评估价值缺乏明确性。此外，他们还提到，计划管理的差异导致了管辖范围内沟通模式的碎片化和培训的不一致。鉴于目前居住在 NH 中的 SMI 患者数量众多，政策和实践应该采取以患者为中心的方法来评估如何更好地利用 PASRR 来满足患者的需求。
