2011-2019 年养老院床位供应趋势。
Trends in Supply of Nursing Home Beds, 2011-2019.
机构信息
Division of Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia.
出版信息
JAMA Netw Open. 2023 Mar 1;6(3):e230640. doi: 10.1001/jamanetworkopen.2023.0640.
IMPORTANCE
Nursing homes play a vital role in providing postacute and long-term care for individuals whose needs cannot be met in the home or community. Whether the supply of nursing home beds and, specifically, the supply of high-quality beds has kept pace with the growth of the older adult population is unknown.
OBJECTIVE
To describe changes in the supply of population-adjusted nursing home beds from 2011 to 2019.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study examines changes in the population-adjusted supply of nursing home beds across all US counties from 2011 to 2019 and describes county and nursing home characteristics where the supply of nursing home beds has increased vs decreased.
MAIN OUTCOMES AND MEASURES
Number of nursing home beds adjusted per 10 000 adults aged 65 years and older.
RESULTS
The population-adjusted supply of nursing home beds declined from 2011 to 2019 for 86.4% of US counties, by a mean (SD) of 129.9 (123.8) beds per 10 000 adults aged 65 years or older per county from a baseline mean (SD) of 552.5 (274.4) beds per 10 000 adults aged 65 years or older per county in 2011. The share of beds that were high quality (4- or 5-star ratings) also declined, which was driven by a small number of counties where nursing home bed supply increased due to a proliferation of lower-quality beds. Simultaneously, metropolitan counties with declining numbers of nursing home beds also experienced declining number of senior housing residential beds (-11.3 [54.6] beds per 10 000 adults aged 65 years or older per county from a baseline mean [SD] of 354.8 [222.3]).
CONCLUSIONS AND RELEVANCE
The findings of this cross-sectional study suggest that the supply of nursing home beds, specifically high-quality nursing home beds, and senior residential housing beds have not kept pace with the demographics of an aging population. Understanding the supply of high-quality nursing home beds and associated geographic variation can inform targeted policies to best support older adults requiring nursing home care.
重要性
养老院在为那些无法在家或社区得到满足的个人提供急性后期和长期护理方面发挥着至关重要的作用。养老院病床的供应情况，特别是高质量病床的供应情况是否跟上了老年人口的增长，目前还不得而知。
目的
描述 2011 年至 2019 年期间，经过人口调整的养老院病床供应的变化情况。
设计、地点和参与者：本横断面研究考察了 2011 年至 2019 年期间，全美所有县经过人口调整的养老院病床供应的变化情况，并描述了养老院病床供应增加和减少的县和养老院特征。
主要结果和测量指标
每 10000 名 65 岁及以上老年人调整后的养老院病床数量。
结果
2011 年至 2019 年期间，86.4%的美国县的养老院病床供应出现下降，每个县每 10000 名 65 岁及以上老年人的病床数量平均（标准差）减少了 129.9（123.8）张，而每个县每 10000 名 65 岁及以上老年人的病床数量基线平均值（标准差）为 552.5（274.4）张。高质量（4 或 5 星级评级）病床的比例也有所下降，这是由于少数县的养老院病床供应因低质量病床的大量增加而增加所致。与此同时，养老院病床数量下降的大都市县也经历了养老院病床数量的下降（每 10000 名 65 岁及以上老年人的病床数量平均减少 11.3（54.6）张，而基线平均值（标准差）为 354.8（222.3）张）。
结论和相关性
本横断面研究的结果表明，养老院病床的供应情况，特别是高质量养老院病床和老年人居住住房的供应情况，并没有跟上人口老龄化的步伐。了解高质量养老院病床的供应情况和相关的地域差异，可以为支持需要养老院护理的老年人提供有针对性的政策。
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