Determinants of Successful Nursing Home Accreditation

Abstract

Objectives: This study examined the factors associated with better accreditation outcomes among nursing homes. Method: A total of 538 nursing homes in Taiwan were included in this study. Measures included accreditation scores, external factors (household income, Herfindahl–Hirschman Index, old-age dependency ratio, population density, and number of older adult households), organizational factors (hospital-based status, chain-affiliated status, occupancy rate, the number of registered nurses or nurse aides per bed, and bed size), and internal factors (accountability, deficiencies, person-centered care, nursing skills, quality control, and integrated care). Results: Bed size, hospital-based status, accountability, deficiencies, person-centered care, nursing skills, quality control, and integrated care were found to predict accreditation. Conclusion: Among all variables in this study, the quality indicators contributed to the most variation, followed by organizational factors. External environmental factors played a minor role in predicting accreditation. A focus on quality of care would benefit not only the residents of a nursing home but also facilitate its accreditation.

Market characteristics and entry strategy decision making: The market perspective of Croatian elderly care homes

“…population seems to have the same effect as in Yeh et al (2021) andFulton (2017). Further, both papers used household income variable and obtained contradictory results, while Fulton's (2017) analysis revealed the negative impact of unemployment level on HHI.…”

“…However, a comparison of here presented results should be made with caution. Namely, these two studies, even though they follow the same logic regarding the LTC sector as a segment of the health sector, are different since one is focused on determinants of accreditation scores for nursing homes (Yeh et al, 2021) and the other on the market concentration for hospitals, physician organizations and health insurers (Fulton, 2017).…”

“…In that sense, Gandhi, Song and Upadrashta (2020) focused on the impact of private equity acquisitions on the quality of care in US nursing homes. Grant, Kesternich and Van Biesebroeck (2020) analyzed competition between non-profit and for-profit LTC homes in Germany, while Yeh, Tsay, Wang, Lo and Shi (2021) used market concentration as one of the variables that determine nursing home accreditation in Taiwan. Grabowski (2008), on the other hand, deals with several issues related to LTC research and, along with emphasizing unanswered policy questions, raises the question of the construction of standard measures of LTC market boundaries.…”

“…It is calculated by summing the squared market shares of each competing company in the industry, and its value lies between 0 and 10 000 (the higher the value, the more concentrated market; in a monopoly, it is 100 2 =10 000). There are other several widely used market concentration measures, such as concentration ratio and Gini coefficient, but following Yeh et al (2021), Fulton (2017), Forder and Allan (2014), Mosca et al (2010), Zwanziger et al (2002), Zinn (1994) and Nyman (1994) we used HHI. However, the aforementioned studies mainly used the number of beds to measure the size of an elderly care home.…”

“…Or in other words, higher GDP per capita will more likely mean that those in need can afford to be admitted to elderly care homes, which will indirectly attract more entrants to the market and decrease market concentration. These two variables have often been used in studies related to market competition (Yeh et al, 2021;Nyman, 1994;Fulton, 2017, Forder & Allan, 2014.…”