Anderson R A, Hsieh P C, Su H F
Duke University, School of Nursing, Durham, NC 27710, USA.
Res Nurs Health. 1998 Aug;21(4):297-313. doi: 10.1002/(sici)1098-240x(199808)21:4<297::aid-nur3>3.0.co;2-a.
The purpose of this study was to identify patterns of resource allocation that relate to resident outcomes in nursing homes. Data on structure, staffing levels, salaries, cost, case mix, and resident outcomes were obtained from state-level, administrative databases on 494 nursing homes. We identified two sets of comparison groups and showed that the group of homes with the greatest percentage of improvement in resident outcomes had higher levels of registered nurse (RN) staffing and higher costs. However, comparison groups based on best-worst average outcomes did not differ in resource allocation patterns. Additional analysis demonstrated that when controlling for RN staffing, resident outcomes in high- and low-cost homes did not differ. The results suggest that, although RN staffing is more expensive, it is key to improving resident outcomes.
本研究的目的是确定与养老院居民护理结果相关的资源分配模式。从494家养老院的州级行政数据库中获取了有关机构结构、人员配备水平、薪资、成本、病例组合和居民护理结果的数据。我们确定了两组对照组,并表明居民护理结果改善百分比最高的养老院组拥有更高水平的注册护士(RN)配备和更高的成本。然而,基于最佳-最差平均结果的对照组在资源分配模式上并无差异。进一步分析表明,在控制RN配备后,高成本和低成本养老院的居民护理结果并无差异。结果表明,尽管RN配备成本更高,但它是改善居民护理结果的关键。