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Characteristics of Nursing Homes that Affect Resident Outcomes
William D. Spector, PhD
Agency for Health Care Policy and Research
Hitomi Adrianna Takada, MA
New York State Department of Social Services
Although there has been increased interest in using outcomes as measures of quality, few studies have shown a link between structure or process and outcomes. In this analysis, based on approximately 2,500 residents in 80 nursing homes in Rhode Island, multivariate models estimate which aspects of care are associated with resident outcomes after controlling for resident characteristics. Outcomes, measured over a 6-month period included death, functional decline, and functional improvement. Results suggest that higher staff levels and lower RN turnover were related to functional improvement. Facilities with high catheter use, low rates of skin care, and low participation in organized activities were associated with negative outcomes. Facilities with few private-pay residents were also associated with negative outcomes. Receipt of a serious federal citation was associated with improved outcomes. For-profit facilities appeared to be more efficient in use of resources.
Journal of Aging and Health, Vol. 3, No. 4,
427-454 (1991)
DOI: 10.1177/089826439100300401
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|
|
|
|
|
|
|
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|
|
|
|
|
|
|
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October 1, 2007;
47(5):
650 - 661.
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|
|
|
|
|
|
|
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47(5):
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|
|
|
|
|
|
|
N. G Castle, J. Engberg, and D. Liu
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16(3):
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[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. H. Swan and C. Harrington
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April 1, 2007;
19(2):
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[Abstract]
[PDF]
|
|
|
|
|
|
|
T. T.H. Wan, N. J. Zhang, and L. Unruh
Predictors of Resident Outcome Improvement in Nursing Homes
West J Nurs Res,
December 1, 2006;
28(8):
974 - 993.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. Donoghue and N. G. Castle
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July 1, 2006;
28(4):
454 - 472.
[Abstract]
[PDF]
|
|
|
|
|
|
|
N. G. Castle
Measuring Staff Turnover in Nursing Homes
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April 1, 2006;
46(2):
210 - 219.
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[Full Text]
[PDF]
|
|
|
|
|
|
|
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45(6):
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|
|
|
|
|
|
|
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September 1, 2005;
60(9):
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[Full Text]
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|
|
|
|
|
|
|
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62(2):
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[Abstract]
[PDF]
|
|
|
|
|
|
|
K. Krichbaum, V. Pearson, K. Savik, and C. Mueller
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27(3):
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[Abstract]
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|
|
|
|
|
|
|
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|
|
|
|
|
|
|
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62(1):
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[Abstract]
[PDF]
|
|
|
|
|
|
|
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61(1):
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[Abstract]
[PDF]
|
|
|
|
|
|
|
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44(1):
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|
|
|
|
|
|
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44(1):
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|
|
|
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|
|
|
|
|
|
|
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[Abstract]
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|
|
|
|
|
|
|
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|
|
|
|
|
|
|
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|
|
|
|
|
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|
|
|
|
|
|
|
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43(90002):
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|
|
|
|
|
|
|
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43(90002):
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[Abstract]
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|
|
|
|
|
|
|
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43(90002):
47 - 57.
[Abstract]
[Full Text]
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|
|
|
|
|
|
|
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April 1, 2003;
43(90002):
76 - 84.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
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February 1, 2003;
22(1):
89 - 103.
[Abstract]
[PDF]
|
|
|
|
|
|
|
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American Journal of Medical Quality,
January 1, 2003;
18(1):
21 - 37.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. Drebing, E. F. McCarty, and N. B. E. Lombardo
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American Journal of Alzheimer's Disease and Other Dementias,
November 1, 2002;
17(6):
357 - 366.
[Abstract]
[PDF]
|
|
|
|
|
|
|
K. Walshe and C. Harrington
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August 1, 2002;
42(4):
475 - 487.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. G. Castle
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December 1, 2001;
41(6):
757 - 767.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Harrington, S. Woolhandler, J. Mullan, H. Carrillo, and D. U. Himmelstein
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September 1, 2001;
91(9):
1452 - 1455.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. T. Mullan and C. Harrington
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Research on Aging,
September 1, 2001;
23(5):
503 - 531.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. Rosen, J. Wu, B.-H. Chang, D. Berlowitz, C. Rakovski, A. Ash, and M. Moskowitz
Risk Adjustment for Measuring Health Outcomes: An Application in VA Long term Care
American Journal of Medical Quality,
July 1, 2001;
16(4):
118 - 127.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. Harrington
Nursing Facility Staffing Policy: A Case Study for Political Change
Policy Politics Nursing Practice,
May 1, 2001;
2(2):
117 - 127.
[Abstract]
[PDF]
|
|
|
|
|
|
|
N. G. Castle
Innovation in Nursing Homes: Which Facilities Are the Early Adopters?
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April 1, 2001;
41(2):
161 - 172.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
C. Harrington, D. Zimmerman, S. L. Karon, J. Robinson, and P. Beutel
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J. Gerontol. B. Psychol. Sci. Soc. Sci.,
September 1, 2000;
55(5):
278S - 287.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
N. G. Kutner, E. F. Mistretta, H. X. Barnhart, and B. F. Belodoff
Family Members' Perceptions of Quality of Life Change in Dementia SCU Residents
Journal of Applied Gerontology,
December 1, 1999;
18(4):
423 - 439.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. Harrington and H. Carrillo
The Regulation and Enforcement of Federal Nursing Home Standards, 1991-1997
Med Care Res Rev,
December 1, 1999;
56(4):
471 - 494.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. Harrington, J. Mullan, L. C. Woodruff, S. G. Burger, H. Carrillo, and B. Bedney
Stakeholders' Opinions Regarding Important Measures of Nursing Home Quality for Consumers
American Journal of Medical Quality,
May 1, 1999;
14(3):
124 - 132.
[Abstract]
[PDF]
|
|
|
|
|
|
|
N. G. Castle
Changes in Resident and Facility Risk Factors for Psychotropic Drug Use in Nursing Homes Since the Nursing Home Reform Act
Journal of Applied Gerontology,
March 1, 1999;
18(1):
77 - 98.
[Abstract]
[PDF]
|
|
|
|
|
|
|
D. R. Berlowitz, J. J. Anderson, G. H. Brandeis, L. A. Lehner, H. K. Brand, A. S. Ash, and M. A. Moskowitz
Pressure Ulcer Development in the VA: Characteristics of Nursing Homes Providing Best Care
American Journal of Medical Quality,
January 1, 1999;
14(1):
39 - 44.
[Abstract]
[PDF]
|
|
|
|
|
|
|
W. D. Spector and D. B. Mukamel
Using Outcomes to Make Inferences about Nursing Home Quality
Eval Health Prof,
September 1, 1998;
21(3):
291 - 315.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. Harrington, H. Carrillo, J. Mullan, and J. H. Swan
Nursing Facility Staffing in the States: The 1991 to 1995 Period
Med Care Res Rev,
September 1, 1998;
55(3):
334 - 363.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. M. Bliesmer, M. Smayling, R. L. Kane, and I. Shannon
The Relationship between Nursing Staffing Levels and Nursing Home Outcomes
J Aging Health,
August 1, 1998;
10(3):
351 - 371.
[Abstract]
[PDF]
|
|
|
|
|
|
|
N. G. Castle
Physical Restraints in Nursing Homes: A Review of the Literature Since the Nursing Home Reform Act of 1987
Med Care Res Rev,
June 1, 1998;
55(2):
139 - 170.
[Abstract]
[PDF]
|
|
|
|
|
|
|
N. G. Castle and D. G. Shea
The Effects of For-Profit and Not-for-Profit Facility Status on the Quality of Care for Nursing Home Residents with Mental Illnesses
Research on Aging,
March 1, 1998;
20(2):
246 - 263.
[Abstract]
|
|
|
|
|
|
|
N. G. Castle and D. G. Shea
Mental Health Services and the Mortality of Nursing Home Residents
J Aging Health,
November 1, 1997;
9(4):
498 - 513.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. B. Moseley
The Impact of Restraints on Nursing Home Resident Outcomes
American Journal of Medical Quality,
June 1, 1997;
12(2):
94 - 102.
[Abstract]
[PDF]
|
|
|
|
|
|
|
J. S. Zinn, D. Brannon, and R. Weech
Quality Improvement in Nursing Care Facilities: Extent, Impetus, and Impact
American Journal of Medical Quality,
March 1, 1997;
12(1):
51 - 61.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. F. Coburn, J. T. Fralich, C. McGuire, and R. H. Fortinsky
Variations in Outcomes of Care in Urban and Rural Nursing Facilities in Maine
Journal of Applied Gerontology,
June 1, 1996;
15(2):
202 - 223.
[Abstract]
[PDF]
|
|
|
|
|
|
|
J. S. Zinn
Market Competition and the Quality of Nursing Home Care
Journal of Health Politics Policy and Law,
September 1, 1994;
19(3):
555 - 582.
[Abstract]
[PDF]
|
|
|
|
|
|
|
R. I, Shorr, R. L. Fought, and W. A. Ray
Changes in Antipsychotic Drug Use in Nursing Homes During Implementation of the OBRA-87 Regulations
JAMA,
February 2, 1994;
271(5):
358 - 362.
[Abstract]
[PDF]
|
|
|
|
|
|
|
E. P. Sabin
Social Relationships and Mortality Among the Elderly
Journal of Applied Gerontology,
March 1, 1993;
12(1):
44 - 60.
[Abstract]
[PDF]
|
|
|
|
|
