Staffing subsidies and the quality of care in nursing homes

Foster Andrew D.; Lee Yong Suk

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Staffing subsidies and the quality of care in nursing homes

机译：养老院人员配备补贴和护理质量

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Concerns about the quality of state-financed nursing home care has led to the wide-scale adoption by states of pass-through subsidies, in which Medicaid reimbursement rates are directly tied to staffing expenditure. We examine the effects of Medicaid pass-through on nursing home staffing and quality of care by adapting a two-step FGLS method that addresses clustering and state-level temporal autocorrelation. We find that pass-through subsidies increases staffing by about 1% on average and 2.7% in nursing homes with a low share of Medicaid patients. Furthermore, pass-through subsidies reduce the incidences of pressure ulcer worsening by about 0.9%. (C) 2015 Elsevier B.V. All rights reserved.

机译：对国家资助的养老院护理质量的担忧导致各州广泛采用直通补贴，其中医疗补助的报销率直接与人员支出挂钩。我们通过调整解决聚类和状态级时间自相关的两步FGLS方法，研究了医疗补助传递对疗养院人员配备和护理质量的影响。我们发现，直通补贴使医疗补助患者比例较低的疗养院平均增加了约1％的人员，而增加了2.7％。此外，通过补贴可以将压疮的发生率降低约0.9％。（C）2015 Elsevier B.V.保留所有权利。

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《Journal of health economics》 |2015年第5期|133-147|共15页
作者
Foster Andrew D.; Lee Yong Suk;
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作者单位

Brown Univ, Dept Econ, Providence, RI 02912 USA;

Stanford Univ, Freeman Spogli Inst Int Studies, Stanford, CA 94305 USA;

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正文语种 eng
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关键词
Medicaid; Wage pass-through; Nursing home; Quality of care; FGLS;

机译：医疗补助;工资传递;疗养院;护理质量;FGLS;

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1. A.Martin1,N.Boyle2,J.Cooke3,S.P.Kennelly4,R.Martin5,M.Mulroy6,M.O’Connor7,S.O'Keeffe8,D.O’Neill4OnbehalfoftheIrishSocietyofPhysiciansinGeriatricMedicine.1.BeaumontHospital,Dublin.2.St.Vincent’sUniversityHospital,Dublin.3.UniversityHospitalWaterford.4.TallaghtUniversityHospital,Dublin.5.ConnollyHospital,Dublin.6.OurLadyofLourdesHospital,Drogheda.7.CorkUniversityHospital.8.GalwayUniversityHospital.AbstractResidents in nursing home care have borne a disproprtionate morbidity and mortality in the COVID-19 pandemic in comparison to the general population. Although the high rate of infection, morbidity and mortality in older people living in nursing homes may be attributable to increased levels of frailty and comorbidity in residents, the physical infrastructure and governance structures within nursing homes is also likely to be highly significant. The authors present, on behalf of Irish Society of Physicians in Geriatric Medicine, a position paper on changes that should be implemented to enhance the safety and quality of care for nursing home residents in Ireland. IntroductionResidentsinnursinghomesrepresentagroupwithhighlevelsofdisabilityandco-morbiditywhichrenderthemparticularlyvulnerabletoexternalandinternalstressors1,asexemplifiedbythehighdeathrateinIrishnursinghomesduringtheCOVID-19pandemic.Atthelastcensusin2016were22,762peopleover65yearsofage(3.7%)listedasresidentinnursinghomesinIreland2.Althoughthiswasadecreaseintheproportionoftheolderpopulationinresidentialcarefrom2011itreflectsanactualincreaseof9.4%inpeoplelivinginnursinghomesinthiscountry.Asoursocietyagesitwillbeincreasinglyimportanttoprovidehighqualitycareforthisvulnerablegroup.TheIrishSocietyofPhysiciansinGeriatricMedicine(ISPGM)haspromotedthedevelopmentofimprovedstandardsofcareinresidentialcareforseveraldecadesandwasthefirstIrishprofessionalgrouptoformulateimprovedstandardsofcarein2001,publishedintheIrishMedicalJournal3. [J] . Irish medical journal. . 2020,第9期

机译：A.Martin1，N.Boyle2，J.Cooke3，SPKennelly4，R.Martin5，M.Mulroy6，M.O'Connor7，S.O'Keeffe8，D.O'Neill4OnbehalfoftheIrishSocietyofPhysiciansinGeriatricMedicine.1.BeaumontHospital，Dublin.2.St .Vincent'sUniversityHospital，Dublin.3.UniversityHospitalWaterford.4.TallaghtUniversityHospital，Dublin.5.ConnollyHospital，Dublin.6.OurLadyofLourdesHospital，在家庭护理Drogheda.7.CorkUniversityHospital.8.GalwayUniversityHospital.AbstractResidents已经结出一个disproprtionate发病率和死亡率在COVID-19大流行相比于普通人群。虽然感染，发病率和死亡率在生活在养老院的老年人率高可能是由于增加了居民的脆弱性和合并症的水平，养老院内的物理基础设施和治理结构，也可能是非常显著。作者提出，对应该实施，加强安全和医疗质量养老院在爱尔兰的变化代表在老年医学，意见书医生的爱尔兰社会。 IntroductionResidentsinnursinghomesrepresentagroupwithhighlevelsofdisabilityandco-morbiditywhichrenderthemparticularlyvulnerabletoexternalandinternalstressors1，asexemplifiedbythehighdeathrateinIrishnursinghomesduringtheCOVID-19pandemic.Atthelastcensusin2016were22,762peopleover65yearsofage（3.7％）listedasresidentinnursinghomesinIreland2.Althoughthiswasadecreaseintheproportionoftheolderpopulationinresidentialcarefrom2011itreflectsanactualincreaseof9.4％inpeoplelivinginnursinghomesinthiscountry.Asoursocietyagesitwillbeincreasinglyimportanttoprovidehighqualitycareforthisvulnerablegroup.TheIrishSocietyofPhysiciansinGeriatricMedicine（ISPGM）haspromotedthedevelopmentofimprovedstandardsofcareinresidentialcareforseveraldecadesandwasthefirstIrishprofessionalgrouptoformulateimprovedstandardsofcarein2001，publishedintheIrishMedicalJournal3。
2. Staffing ratios and quality: an analysis of minimum direct care staffing requirements for nursing homes. [J] . Bowblis JR Health services research: HSR . 2011,第5期

机译：人员配置比率和质量：养老院最低直接护理人员配置要求的分析。
3. Examining the Effects of Professional Non-Nursing Staffing on Quality of Care in Nursing Homes [J] . Ian Livingstone Archives of Physical Medicine and Rehabilitation . 2018,第12期

机译：检查专业非护理人员对护理家庭护理质量的影响
4. An intelligent performance assessment system for enhancing the service quality of home care nursing staff in the healthcare industry [C] . Valerie Tang, K.L. Choy, Paul K.Y. Siu, Portland International Conference on Management of Engineering and Technology . 2016

机译：智能绩效评估系统，可提高医疗保健行业中家庭护理人员的服务质量
5. The effects of state minimum staffing standards on staffing, quality of care, and financial performance in nursing homes. [D] . Park, Jeongyoung. 2007

机译：州最低人员配备标准对疗养院人员配备，护理质量和财务绩效的影响。
6. Staffing Ratios and Quality: An Analysis of Minimum Direct Care Staffing Requirements for Nursing Homes [O] . John R Bowblis 2011

机译：人员比例和质量：养老院最低直接护理人员需求分析
7. 1 Staffing Subsidies and the Quality of Care in Nursing Homes [O] . Andrew D. Foster, Yong Suk Lee 2013

机译：1人员补贴和护理院的护理质量
8. Nurse Staffing Levels and Quality of Care in Rural Nursing Homes. Policy Brief. [R] . Hung, P., Casey, M., Moscovice, I. 2015

机译：护理人员配置水平与农村护理院的护理质量。政策简报。

Staffing subsidies and the quality of care in nursing homes

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