Evaluating Nursing Home Performance Indicators: An Illustration Exploring the Impact of Facilities on ADL Change

Phillips, Charles D.; Shen, Ruijie; Chen, Min; Sherman, Michael P.

doi:10.1093/geront/47.5.683

Cited by 22 publications

(25 citation statements)

References 14 publications

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“…At the resident level, older age and a lower care‐need level at baseline were significantly associated with care‐need level deterioration, as documented in earlier studies …”

Section: Discussionsupporting

confidence: 74%

“…In addition, at the resident level, the clinical diagnosis and cognitive functioning were not considered because of the limited information in our dataset . Second, we based our findings on five functional status levels, and the very limited information might be different from previous studies, such as that carried out by Phillips et al , who based their study on ADL measures . Additionally, some research, including the present study, used care‐need level as an outcome, because the evaluation process of care‐need level is strictly carried out by the government, and a strong correlation between care‐need level and ADL was found in a previous study .…”

Section: Discussionmentioning

confidence: 90%

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Resident and facility characteristics associated with care‐need level deterioration in long‐term care welfare facilities in Japan

Jin

Tamiya

Jeon

et al. 2018

Geriatrics Gerontology Int

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Aim: To determine the resident and facility characteristics associated with residents' care-need level deterioration in long-term care welfare facilities in Japan.Methods: A nationally representative sample of 358 886 residents who lived in 3774 long-term care welfare facilities for at least 1 year from October 2012 was obtained from long-term care insurance claims data. Facility characteristics were linked with a survey of institutions and establishments for long-term care in 2012. We used a multilevel logistic regression according to the inclusion and exclusion of lost to follow-up to define the resident and facility characteristics associated with resident care-need level deteriorations (lost to follow-up: the majority were hospitalized residents or had died; were treated as deterioration in the including loss to follow-up model).Results: Adjusting for the covariates, at the resident level, older age and lower care-need level at baseline were more likely to show deterioration in the care-need level. At the facility level, metropolitan facilities, unit model (all private room settings) and mixed-model facilities (partly private room settings) were less likely to experience careneed level deterioration. A higher proportion of registered nurses among all nurses was negatively related to careneed level deterioration only in the model including lost to follow-up. A higher proportion of registered dietitians among all dietitians and the facilities in business for fewer years were negatively associated with care-need level deterioration only in the model excluding lost to follow-up. Conclusions:The present study could help identify residents who are at risk of care-need level deterioration, and could contribute to improvements in provider quality performance and enhance competence in the market. Geriatr Gerontol Int 2018; 18: 758-766.

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“…At the resident level, older age and a lower care‐need level at baseline were significantly associated with care‐need level deterioration, as documented in earlier studies …”

Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 90%

Resident and facility characteristics associated with care‐need level deterioration in long‐term care welfare facilities in Japan

Jin

Tamiya

Jeon

et al. 2018

Geriatrics Gerontology Int

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show abstract

“…The previous studies of ADL change tested ADL outcome after 3 or 6 months after baseline (Buttar et al, 2001;Phillips, Shen, Chen, & Sherman, 2007) and the result of Phillips et al reported better explanatory power in model after 6 month than 3 month. Therefore, the outcome variable of this study was the ADL score 6 months after baseline.…”

Section: )Outcomevariablementioning

confidence: 99%

Factors Impacting the Physical Function of Older Adults in Korean Long-Term Care Hospitals

2011

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Purpose: This study was conducted to examine activities of daily living (ADL) of older adults admitted to Korean long-term care hospitals (LTCHs), and to explore the patient and organizational factors that have an impact on the ADL of this population. Methods: A secondary analysis of the Korean minimum data set (K-MDS) of patients (N= 14,369) and of the profiles of LTCHs (N= 358) from the Health Insurance Review and Assessment Service was done between January and July 2008. The outcome variable was ADL score 6 months after baseline assessment. Multi-level linear regression was employed to explore the patient and organizational factors that affected ADL scores. Results: Of the patients, 45.4% had a baseline ADL score of between 31 and 40, with a score of 40 indicating that the patient was entirely dependent for all items. None of the organizational characteristics were significantly associated with effects on the ADLs of older adults who had been in a LTHC for at least 6 months. However, patient characteristics, such as age, baseline ADL, frequency of physical therapy, urinary incontinence, fecal incontinence, pressure ulcers, and having a tube or catheter, were significantly associated with ADL 6 months after baseline. Conclusion: In order to maintain and improve the ADL of older adults in LTCHs, we should develop strategies to prevent urinary and fecal incontinence, pressure ulcers, unnecessary tubes or catheters, providing adequate physical therapy. Additional studies should include more detailed information regarding nursing staff, including RN hours for direct care, education level and turnover.

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“…The majority of persons in nursing homes are lacking in one or more basic activities of daily living (ADL) (16,17). About half of the residents are over 85 years of age (18).…”

Section: Characteristics Of Nursing Home Residentsmentioning

confidence: 99%

Clinical practice in nursing homes as a key for progress

Morley

2010

The Journal of nutrition, health and aging

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With the aging of the world's population there has become a major need for the development of nursing homes throughout the world. While some countries provide high quality care for the disabled elderly, in others this is not the case. Education of a medical director has been shown to improve the quality of the nursing home. Physicians need to have knowledge of how to implement continuous quality improvement and culture change. Key medical issues include moving to a restraint free environment, subsyndromal delirium, behavioral disturbances, weight loss, pain management, pressure ulcers, falls, hip fractures, polypharmacy, depression and frailty.

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Evaluating Nursing Home Performance Indicators: An Illustration Exploring the Impact of Facilities on ADL Change

Cited by 22 publications

References 14 publications

Resident and facility characteristics associated with care‐need level deterioration in long‐term care welfare facilities in Japan

Resident and facility characteristics associated with care‐need level deterioration in long‐term care welfare facilities in Japan

Factors Impacting the Physical Function of Older Adults in Korean Long-Term Care Hospitals

Clinical practice in nursing homes as a key for progress

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