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Changes in nursing home staffing levels, 1997 to 2007. 一九九七年至二零零七年护养院人手数目的变化。
IF 2.5
Medical care research and review : MCRR Pub Date : 2010-04-01 Epub Date: 2009-08-11 DOI: 10.1177/1077558709342253
Binyam K Seblega, Ning Jackie Zhang, Lynn Y Unruh, Gerald-Mark Breen, Seung Chun Paek, Thomas T H Wan
{"title":"Changes in nursing home staffing levels, 1997 to 2007.","authors":"Binyam K Seblega,&nbsp;Ning Jackie Zhang,&nbsp;Lynn Y Unruh,&nbsp;Gerald-Mark Breen,&nbsp;Seung Chun Paek,&nbsp;Thomas T H Wan","doi":"10.1177/1077558709342253","DOIUrl":"https://doi.org/10.1177/1077558709342253","url":null,"abstract":"<p><p>A positive relationship has been demonstrated between the quality of care delivered in nursing homes and the quality of nursing staff providing the care. The general perception, however, is that there is a decline in registered nurses' staff hours in nursing homes. The primary objective of this study is to investigate whether the levels of registered nurses (RNs), licensed practical nurses (LPNs), and nursing assistants (NAs) as well as skill mix has changed in nursing homes between the years 1997 and 2007. A descriptive research design was employed on data derived from Online Survey Certification and Reporting System database. After accounting for facility size and ownership, it was found that more nursing homes have increased-rather than decreased-LPN and NA hours per resident day between 1997 and 2007. On the other hand, more nursing homes have decreased-rather than increased-RN hours per resident day and skill mix during the same time period.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"232-46"},"PeriodicalIF":2.5,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558709342253","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40027827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 37
Review: engaging patients as vigilant partners in safety: a systematic review. 综述：使患者成为安全方面警惕的伙伴：一项系统综述。
Medical care research and review : MCRR Pub Date : 2010-04-01 Epub Date: 2009-08-11 DOI: 10.1177/1077558709342254
David L B Schwappach
{"title":"Review: engaging patients as vigilant partners in safety: a systematic review.","authors":"David L B Schwappach","doi":"10.1177/1077558709342254","DOIUrl":"10.1177/1077558709342254","url":null,"abstract":"<p><p>Several initiatives promote patient involvement in error prevention, but little is known about its feasibility and effectiveness. A systematic review was conducted on the evidence of patients' attitudes toward engagement in error prevention and the effectiveness of efforts to increase patient participation. Database searches yielded 3,840 candidate articles, of which 21 studies fulfilled the inclusion criteria. Patients share a positive attitude about engaging in their safety at a general level, but their intentions and actual behaviors vary considerably. Studies applied theories of planned behavior and indicate that self-efficacy, preventability of incidents, and effectiveness of actions seem to be central to patients' intention to engage in error prevention. Rigorous evaluations of major educational campaigns are lacking. Interventions embedded within clinical settings have been effective to some extent. Evidence suggests that involvement in safety may be successful if interventions promote complex behavioral change and are sensitively implemented in health care settings.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"119-48"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40027826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Racial/ethnic differences in patients' perceptions of inpatient care using the HCAHPS survey. 使用HCAHPS调查患者对住院治疗的看法的种族/民族差异。
IF 2.5
Medical care research and review : MCRR Pub Date : 2010-02-01 Epub Date: 2009-08-03 DOI: 10.1177/1077558709341066
Elizabeth Goldstein, Marc N Elliott, William G Lehrman, Katrin Hambarsoomian, Laura A Giordano
{"title":"Racial/ethnic differences in patients' perceptions of inpatient care using the HCAHPS survey.","authors":"Elizabeth Goldstein,&nbsp;Marc N Elliott,&nbsp;William G Lehrman,&nbsp;Katrin Hambarsoomian,&nbsp;Laura A Giordano","doi":"10.1177/1077558709341066","DOIUrl":"https://doi.org/10.1177/1077558709341066","url":null,"abstract":"<p><p>Using HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems, also known as the CAHPS Hospital Survey) data from 2,684 hospitals, the authors compare the experiences of Hispanic, African American, Asian/Pacific Islander, American Indian/Alaska Native, and multiracial inpatients with those of non-Hispanic White inpatients to understand the roles of between- and within-hospital differences in patients' perspectives of hospital care. The study finds that, on average, non-Hispanic White inpatients receive care at hospitals that provide better experiences for all patients than the hospitals more often used by minority patients. Within hospitals, patient experiences are more similar by race/ethnicity, though some disparities do exist, especially for Asians. This research suggests that targeting hospitals that serve predominantly minority patients, improving the access of minority patients to better hospitals, and targeting the experiences of Asians within hospitals may be promising means of reducing disparities in patient experience.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"74-92"},"PeriodicalIF":2.5,"publicationDate":"2010-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558709341066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40009608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 164
Measuring adequacy of coverage for the privately insured: new state estimates to monitor trends in health insurance coverage. 衡量私人保险覆盖的充分性:监测健康保险覆盖趋势的新州估计。
IF 2.5
Medical care research and review : MCRR Pub Date : 2009-04-01 Epub Date: 2009-01-16 DOI: 10.1177/1077558708330426
Lynn A Blewett, Holly Rodin, Gestur Davidson, Michael Davern
{"title":"Measuring adequacy of coverage for the privately insured: new state estimates to monitor trends in health insurance coverage.","authors":"Lynn A Blewett,&nbsp;Holly Rodin,&nbsp;Gestur Davidson,&nbsp;Michael Davern","doi":"10.1177/1077558708330426","DOIUrl":"https://doi.org/10.1177/1077558708330426","url":null,"abstract":"<p><p>The privately insured are assuming a greater share of the costs of their health care, yet little is known about changes in out-of-pocket spending at the state level. The central problem is that national surveys with the relevant data are not designed to generate state-level estimates. The study addresses this shortcoming by using a two-sample modeling approach to estimate state-level measures of out-of-pocket spending relative to income for privately insured adults and children. National data from the Medical Expenditure Panel Survey-Household Component and state representative data from the Current Population Survey are used. Variation in out-of-pocket spending over time and across states is shown, highlighting concern about the adequacy of coverage for 2.9% of privately insured children and 7.8% of privately insured adults. Out-of-pocket spending relative to income is an important indicator of access to care and should be monitored at the state level.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"167-80"},"PeriodicalIF":2.5,"publicationDate":"2009-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558708330426","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39997904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Stochastic frontier analysis of hospital inefficiency: a review of empirical issues and an assessment of robustness. 医院效率低下的随机前沿分析:对经验问题的回顾和稳健性评估。
IF 2.5
Medical care research and review : MCRR Pub Date : 2008-04-01 Epub Date: 2007-11-28 DOI: 10.1177/1077558707307580
Michael D Rosko, Ryan L Mutter
{"title":"Stochastic frontier analysis of hospital inefficiency: a review of empirical issues and an assessment of robustness.","authors":"Michael D Rosko,&nbsp;Ryan L Mutter","doi":"10.1177/1077558707307580","DOIUrl":"https://doi.org/10.1177/1077558707307580","url":null,"abstract":"<p><p>Twenty stochastic frontier analysis (SFA) studies of hospital inefficiency in the United States were analyzed. Results from best-practice methods were compared against previously used methods in hospital studies to ascertain the robustness of SFA in estimating cost inefficiency. To compare past studies and analyze new data, SFA methods were varied by (a) the assumptions of the structure of costs and distribution of the error term, (b) inclusion of quality and product descriptor measures, and (c) use of simultaneous and two-stage estimation techniques. SFA results were relatively insensitive to several model variations.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"131-66"},"PeriodicalIF":2.5,"publicationDate":"2008-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558707307580","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41043994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 113
Reducing hospitalizations from long-term care settings. 减少长期护理机构的住院人数。
IF 2.5
Medical care research and review : MCRR Pub Date : 2008-02-01 Epub Date: 2007-09-25 DOI: 10.1177/1077558707307569
R Tamara Konetzka, William Spector, M Rhona Limcangco
{"title":"Reducing hospitalizations from long-term care settings.","authors":"R Tamara Konetzka,&nbsp;William Spector,&nbsp;M Rhona Limcangco","doi":"10.1177/1077558707307569","DOIUrl":"https://doi.org/10.1177/1077558707307569","url":null,"abstract":"<p><p>Hospital spending represents approximately one third of total national health spending, and the majority of hospital spending is by public payers. Elderly individuals with long-term care needs are at particular risk for hospitalization. While some hospitalizations are unavoidable, many are not, and there may be benefits to reducing hospitalizations in terms of health and cost. This article reviews the evidence from 55 peer-reviewed articles on interventions that potentially reduce hospitalizations from formal long-term care settings. The interventions showing the strongest potential are those that increase skilled staffing, especially through physician assistants and nurse practitioners; improve the hospital-to-home transition; substitute home health care for selected hospital admissions; and align reimbursement policies such that providers do not have a financial incentive to hospitalize. Much of the evidence is weak and could benefit from improved research design and methodology.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"40-66"},"PeriodicalIF":2.5,"publicationDate":"2008-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558707307569","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41061826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 140
Characteristics of community nursing homes serving per diem veterans, 1999 to 2002. 1999年至2002年社区养老服务机构按日计薪退伍军人的特点。
IF 2.5
Medical care research and review : MCRR Pub Date : 2007-12-01 Epub Date: 2007-09-18 DOI: 10.1177/1077558707304740
Christopher E Johnson, Robert Weech-Maldonado, Huanguang Jia, Dean Reker, Robert Buchanan, Alexandre Laberge
{"title":"Characteristics of community nursing homes serving per diem veterans, 1999 to 2002.","authors":"Christopher E Johnson,&nbsp;Robert Weech-Maldonado,&nbsp;Huanguang Jia,&nbsp;Dean Reker,&nbsp;Robert Buchanan,&nbsp;Alexandre Laberge","doi":"10.1177/1077558707304740","DOIUrl":"https://doi.org/10.1177/1077558707304740","url":null,"abstract":"<p><p>This study compared the characteristics of community nursing homes where veterans received their care with those of facilities that did not treat veterans from 1999 to 2002 using the Centers for Medicare and Medicaid Services (CMS) Online Survey Certification and Reporting system data merged with the CMS Minimum Data Set. A structure, process, and outcome model was used to examine whether the presence of per diem veterans had any impact on multidimensional quality measures. Facilities with any veterans were less likely to meet recommended nurse staffing standards; more likely to have patients with tube feeding, new catheterizations, and mobility restraints; and more likely to have actual harm citations and new pressure sores, plus quality-of-care, quality-of-life, and total deficiencies, than facilities without veterans. The implications of this study are that the U.S. Department of Veterans Affairs may need to examine its contracting policies with community facilities to understand both quality and selection effects that may be occurring.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"673-90"},"PeriodicalIF":2.5,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558707304740","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40980818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Characteristics of VA patients who use low-quality private-sector CABG centers in New York. 使用纽约低质量私营CABG中心的VA患者的特征
IF 2.5
Medical care research and review : MCRR Pub Date : 2007-12-01 Epub Date: 2007-09-18 DOI: 10.1177/1077558707304738
William B Weeks, Elliott S Fisher
{"title":"Characteristics of VA patients who use low-quality private-sector CABG centers in New York.","authors":"William B Weeks,&nbsp;Elliott S Fisher","doi":"10.1177/1077558707304738","DOIUrl":"https://doi.org/10.1177/1077558707304738","url":null,"abstract":"<p><p>Little is known about the quality of care that veterans obtain in the private sector. To explore this issue, we identified the hospital in which 4,008 veterans enrolled in the Veterans Administration (VA) obtained coronary artery bypass graft (CABG) surgery in the New York private sector between 1997 and 2000. We used published risk-adjusted mortality rates to assign New York CABG centers to performance quintiles. VA patients with the lowest incomes were 2.4 times more likely than those in the highest incomes to use the highest-mortality hospitals (95 percent CI: 2.0-3.0). Compared with white patients, black (OR 1.8; 95 percent CI: 1.2-2.8) and Hispanic VA patients (OR 1.6; 95 percent CI: 0.9-2.8) were more likely to use the highest-mortality hospitals. About one third of patients using the highest-mortality hospitals lived closer to low-mortality hospitals. Efforts to direct VA patients' care to high-performance hospitals could improve outcomes and reduce racial and ethnic disparities in care.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"691-705"},"PeriodicalIF":2.5,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558707304738","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40980715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
How federal and state policies affected hospital uncompensated care provision in the 1990s. 20世纪90年代，联邦和州的政策如何影响医院的无偿护理服务。
IF 2.5
Medical care research and review : MCRR Pub Date : 2007-12-01 DOI: 10.1177/1077558707305940
Anthony T Lo Sasso, Dorian G Seamster
{"title":"How federal and state policies affected hospital uncompensated care provision in the 1990s.","authors":"Anthony T Lo Sasso,&nbsp;Dorian G Seamster","doi":"10.1177/1077558707305940","DOIUrl":"https://doi.org/10.1177/1077558707305940","url":null,"abstract":"<p><p>The 1990s featured pronounced policy change that had important effects on safety net providers and their ability to care for the uninsured. The authors examined how changes in public policy affected hospital uncompensated care (UC) between 1990 and 2000. They found that aggregate state Medicaid Disproportionate Share Hospital spending had no impact on UC provision. Expanding public health insurance eligibility for children and adults and increasing Medicaid managed care had small negative effects on UC provision. State and local tax appropriations had the largest impact on UC provision. A better understanding of the effect of health care policies on UC provision is essential in crafting new policies and better anticipating their impact.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"731-44"},"PeriodicalIF":2.5,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558707305940","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41043995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 13
Factors influencing organ donation decisions by African Americans: a review of the literature. 影响非裔美国人器官捐赠决定的因素:文献综述。
IF 2.5
Medical care research and review : MCRR Pub Date : 2007-10-01 DOI: 10.1177/1077558707304644
Richard S Kurz, Darcell P Scharff, Tanchica Terry, Shanica Alexander, Amy Waterman
{"title":"Factors influencing organ donation decisions by African Americans: a review of the literature.","authors":"Richard S Kurz,&nbsp;Darcell P Scharff,&nbsp;Tanchica Terry,&nbsp;Shanica Alexander,&nbsp;Amy Waterman","doi":"10.1177/1077558707304644","DOIUrl":"https://doi.org/10.1177/1077558707304644","url":null,"abstract":"<p><p>The purpose of this article is to review the literature from 1980 to 2005 regarding organ donation decision making by African Americans for themselves and their loved ones and recommend improvements in subsequent studies. Using the behavioral model of health services utilization as an organizing framework, the review procedure consists of a (1) search of health and medical literature using several key words and eight indexes, (2) selection of articles based on specific criteria, and (3) review of each article with regard to the population and sample used, study design, dependent variables addressed, and its findings. The review indicates that predisposing, enabling, and need factors each influence African Americans' organ donation decision making. Retrospective chart reviews provide a good design for future multivariate analyses of the many factors influencing African American decision making. Interventions to influence decision making should emphasize both community education and the process of organ procurement.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"475-517"},"PeriodicalIF":2.5,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558707304644","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40983151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 44
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