Case mix adjustment in nursing systems research: The case of resident outcomes in nursing homes

Anderson, Ruth A.; Su, Huifang; Hsieh, Pi‐Ching; Allred, Charlene A.; Owensby, Sue; Joiner-Rogers, Glenda

doi:10.1002/(sici)1098-240x(199908)22:4<271::aid-nur2>3.0.co;2-6

Cited by 6 publications

(2 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To increase the potential for observing variations in management practices, we purposefully selected NHs that were identified in periodic state regulatory surveys as having higher (N = 2) and lower quality (N = 2). We calculated composite quality scores from Minimum Data Set Quality Indicators, using the algorithm suggested by Anderson et al [45]. Two NHs were randomly selected from those with composite scores falling at the 20th percentile or below and the 80th percentile or above.…”

Section: Resultsmentioning

confidence: 99%

Local interaction strategies and capacity for better care in nursing homes: a multiple case study

Anderson

Toles

Corazzini

et al. 2014

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundTo describe relationship patterns and management practices in nursing homes (NHs) that facilitate or pose barriers to better outcomes for residents and staff.MethodsWe conducted comparative, multiple-case studies in selected NHs (N = 4). Data were collected over six months from managers and staff (N = 406), using direct observations, interviews, and document reviews. Manifest content analysis was used to identify and explore patterns within and between cases.ResultsParticipants described interaction strategies that they explained could either degrade or enhance their capacity to achieve better outcomes for residents; people in all job categories used these ‘local interaction strategies’. We categorized these two sets of local interaction strategies as the ‘common pattern’ and the ‘positive pattern’ and summarize the results in two models of local interaction.ConclusionsThe findings suggest the hypothesis that when staff members in NHs use the set of positive local interaction strategies, they promote inter-connections, information exchange, and diversity of cognitive schema in problem solving that, in turn, create the capacity for delivering better resident care. We propose that these positive local interaction strategies are a critical driver of care quality in NHs. Our hypothesis implies that, while staffing levels and skill mix are important factors for care quality, improvement would be difficult to achieve if staff members are not engaged with each other in these ways.

show abstract

Section: Resultsmentioning

confidence: 99%

Local interaction strategies and capacity for better care in nursing homes: a multiple case study

Anderson

Toles

Corazzini

et al. 2014

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…The dissemination of quality principles in NHs using specific training programmes, the implementation of monitoring systems, and the introduction of specific tools (i.e., the aims of the overall project in which the present study is included) are an answer to both the health needs of elderly residents in long-term care and the need for the most appropriate allocation of the available resources. Enhancing the quality of nutritional care might provide medium- and long-term benefits in residents’ health status and quality of life, ultimately reducing the costs related to the care process [ 18 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

A cross-sectional survey to investigate the quality of care in Tuscan (Italy) nursing homes: the structural, process and outcome indicators of nutritional care

Bonaccorsi

Collini

Castagnoli

et al. 2015

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundPrevious studies have investigated process and structure indicators of nutritional care as well as their use in nursing homes (NHs), but the relative weight of these indicators in predicting the risk of malnutrition remains unclear.Aims of the present study are to describe the quality indicators of nutritional care in older residents in a sample of NHs in Tuscany, Italy, and to evaluate the predictors of protein-energy malnutrition risk.MethodsA cross-sectional survey was conducted in 67 NHs. Information was collected to evaluate quality indicators of nutritional care and the individual risk factors for malnutrition, which was assessed using the Malnutrition Universal Screening Tool. A multilevel model was used to analyse the association between risk and predictors.ResultsOut of 2395 participants, 23.7 % were at high, 11 % at medium, and 65.3 % at low risk for malnutrition. Forty-two percent of the NHs had only a personal scale to weigh residents; 88 % did not routinely use a screening test/tool for malnutrition; 60 % used some standardized approach for weight measurement; 43 % did not assess the severity of dysphagia; 12 % were not staffed with dietitians.Patients living in NHs where a chair or platform scale was available had a significantly lower risk of malnutrition (OR = 0.73; 95 % CI = 0.56–0.94). None of the other structural or process quality indicators showed a statistically significant association with malnutrition risk.ConclusionsOf all the process and structural indicators considered, only the absence of an adequate scale to weigh residents predicted the risk of malnutrition, after adjusting for case mix. These findings prompt the conduction of further investigations on the effectiveness of structural and process indicators that are used to describe quality of nutritional care in NHs.

show abstract

Cascade iatrogenesis: Factors leading to the development of adverse events in hospitalized older adults

Thornlow

Anderson

Oddone

2009

International Journal of Nursing Studies

View full text Add to dashboard Cite

Case mix adjustment in nursing systems research: The case of resident outcomes in nursing homes

Cited by 6 publications

References 15 publications

Local interaction strategies and capacity for better care in nursing homes: a multiple case study

Local interaction strategies and capacity for better care in nursing homes: a multiple case study

A cross-sectional survey to investigate the quality of care in Tuscan (Italy) nursing homes: the structural, process and outcome indicators of nutritional care

Cascade iatrogenesis: Factors leading to the development of adverse events in hospitalized older adults

Contact Info

Product

Resources

About