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Journal of Aging and Health
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Can a Survey Influence Quality of Care in Nursing Homes?

The Impact of the New York Quality Assurance System on Resident Deterioration and Adverse Outcomes

Carolyn E. Schwartz, ScD

Abt Associates, Inc.

Ronald J. Ozmiinkowski, PhD

Abt Associates, Inc.

David C. Hoaglin, PhD

Abt Associates, Inc.

Margot Cella, MS

Abt Associates, Inc.

Laurence G. Branch, PhD

Abt Associates, Inc.

Data from a standardized administrative form, the Patient Review Instrument, were used to evaluate whether the New York Quality Assurance System (NYQAS) had an impact on deterioration in functional status or on the incidence of adverse outcomes among residents in New York's nursing homes. The NYQUAS approach evaluated nursing homes by using "triggers" suggestive of dificient quality of care. A random sample of nursing home facilities was selected from data encompassing 2 years before and 2 years after the implementation of NYQAS in 1988. Growth curve analysis and logistic regression were used to assess the influence of NYQAS on deterioration and on the probability of developing decubitus ulcers or contractures, or of being mechanically restrained. The functional status of most residents did not change significantly over time. After allowing statistically for differences in the resource needs of residents within the facilities, the implementation of NYQAS was associated with decreased deterioration in toileting and/or transferring, depending on the site of care. NYQAS was not associated with changes in incidence rates of decubitus, contractures, or the use of mechanical restraints.

Journal of Aging and Health, Vol. 6, No. 4, 549-572 (1994)
DOI: 10.1177/089826439400600407
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