澳大利亚长期护理机构的星级评定：与高评级相关的机构特征以及评级随时间的变化。
Star Ratings in Long-Term Care Facilities in Australia: Facility Characteristics Associated with High Ratings and Changes in Ratings Over Time.
机构信息
Registry of Senior Australians Research Centre, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia; Registry of Senior Australians Research Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia; Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.
Registry of Senior Australians Research Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.
出版信息
J Am Med Dir Assoc. 2024 Nov;25(11):105272. doi: 10.1016/j.jamda.2024.105272. Epub 2024 Sep 19.
OBJECTIVES
A Star Rating system (1 to 5 stars) of long-term care facilities in Australia is based on 4 sub-categories: compliance, quality measures, residents' experience, and staffing. The objectives were to examine associations between facility characteristics and the odds of receiving a 4- or 5-star rating, and changes in ratings between the earliest reporting period (October-December 2022) to the most recent (April-June 2023).
DESIGN
Cross-sectional, ecological study, with an additional longitudinal component.
SETTING
Long-term care facilities in Australia.
METHODS
Associations between facility characteristics and the odds of receiving a 4- or 5-star rating were examined using a multiple logistic regression model. Average changes in overall star rating and each sub-category weighted by fractional contribution to overall star rating were estimated.
RESULTS
Of 2476 facilities, 53.7% received a 4- or 5-star rating, 44.1% a 3-star rating, and 2.1% a 1- or 2-star rating in the April-June 2023 reporting period. Facility characteristics associated with higher odds of 4- or 5-star ratings included small (≤60 residents) and medium-size (61-100 residents) (odds ratios, 3.16; 95% CI, 2.51-3.98 and 1.72; 95% CI, 1.38-2.13, respectively), and Queensland location compared with New South Wales (2.42; 95% CI, 1.87-3.14). Facilities in socioeconomically disadvantaged areas (0.45; 95% CI, 0.33-0.62) and for-profit (0.12; 95% CI, 0.07-0.22) or not-for-profit facilities (0.16; 95% CI, 0.09-0.29) compared with government-operated were associated with lower odds of 4- or 5-star ratings. Between the 2 reporting periods, 25.1% of facilities' star ratings increased and 10.2% decreased (average change 0.156). Residents' experience, compliance, and staffing had the largest weighted average sub-category rating changes (0.051, 0.042, and 0.042, respectively).
CONCLUSIONS
Smaller size, government ownership, and location in socioeconomically advantaged areas were associated with higher odds of 4- or 5-star ratings in long-term care facilities. Average star ratings increased over time but increases and decreases in overall and sub-category ratings were observed.
目的
澳大利亚的长期护理机构星级评分系统（1 到 5 星）基于 4 个分项：合规性、质量指标、居民体验和人员配备。本研究旨在探讨机构特征与获得 4 或 5 星级评分的几率之间的关联，并评估自最早报告期（2022 年 10 月至 12 月）至最近报告期（2023 年 4 月至 6 月）期间评分的变化情况。
设计
横断面、生态研究，附加纵向分析。
地点
澳大利亚的长期护理机构。
方法
采用多因素逻辑回归模型评估机构特征与获得 4 或 5 星级评分的几率之间的关联。根据对整体星级评分的加权贡献，估计整体星级评分和每个分项的平均变化。
结果
在 2476 家机构中，53.7%的机构在 2023 年 4 月至 6 月报告期内获得了 4 或 5 星级评分，44.1%的机构获得了 3 星级评分，2.1%的机构获得了 1 或 2 星级评分。与获得 4 或 5 星级评分几率较高相关的机构特征包括规模较小（≤60 名居民）和规模中等（61-100 名居民）（比值比，3.16；95%置信区间，2.51-3.98 和 1.72；95%置信区间，1.38-2.13），以及位于昆士兰州而非新南威尔士州（2.42；95%置信区间，1.87-3.14）。位于社会经济劣势地区（0.45；95%置信区间，0.33-0.62）、营利性（0.12；95%置信区间，0.07-0.22）或非营利性（0.16；95%置信区间，0.09-0.29）机构与政府运营机构相比，获得 4 或 5 星级评分的几率较低。在两个报告期之间，25.1%的机构星级评分上升，10.2%的机构星级评分下降（平均变化 0.156）。居民体验、合规性和人员配备的加权平均分项评分变化最大（0.051、0.042 和 0.042）。
结论
规模较小、政府所有和位于社会经济优势地区与长期护理机构获得 4 或 5 星级评分的几率较高相关。平均星级评分随时间增加，但整体和分项评分的上升和下降都有观察到。
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