Rohit Pradhan, Akbar Ghiasi, Ganisher Davlyatov, Shivani Gupta, Robert Weech-Maldonado
{"title":"护理的脉络：机构护理人员对养老院品质的影响。","authors":"Rohit Pradhan, Akbar Ghiasi, Ganisher Davlyatov, Shivani Gupta, Robert Weech-Maldonado","doi":"10.1097/MLR.0000000000002114","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To assess the association of agency nursing staff utilization with nursing home (NH) quality.</p><p><strong>Background: </strong>Nursing staff are the primary caregivers in NHs, where high-quality care is contingent upon their adequacy and expertise. Long-standing staffing challenges, exacerbated by the COVID-19 pandemic, have led NHs to rely on agency/contract labor to alleviate staffing shortages.</p><p><strong>Methods: </strong>This study used the following secondary datasets: Payroll-Based Journal, Care Compare: 5-Star Quality Rating System, LTCFocus.org, Area Health Resource Files, and Rural-Urban Commuting Area codes for 2017-2022. Multivariable ordinal logistic regression with 2-way (facility and year-level) fixed effects was employed. The study included all Centers for Medicare and Medicaid Services certified U.S. NHs. Analytic data comprised 80,244 facilities, averaging 13,374 unique NHs per year. The study focused on the quality star rating (1-5 scale) from the 5-Star Quality Rating System as the dependent variable. Independent variables included the proportion of agency nursing staff hours per resident day for registered nurses, licensed practical nurses, and certified nursing assistants while controlling for facility and community characteristics that may affect NH quality.</p><p><strong>Results: </strong>A 10% increase in agency registered nurses, licensed practical nurses, and certified nursing assistants (logged) was associated with a decrease in the odds of achieving a higher star rating by 4%, 5%, and 4%, respectively (P < 0.001).</p><p><strong>Conclusions: </strong>The use of agency nursing staff can negatively impact NH quality. Efforts to better integrate agency nursing staff into NHs, combined with strategies to recruit and retain permanent nursing staff, could lead to improved outcomes for residents.</p>","PeriodicalId":18364,"journal":{"name":"Medical Care","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Threads of Care: Unraveling the Impact of Agency Nursing Staff on Nursing Home Quality.\",\"authors\":\"Rohit Pradhan, Akbar Ghiasi, Ganisher Davlyatov, Shivani Gupta, Robert Weech-Maldonado\",\"doi\":\"10.1097/MLR.0000000000002114\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To assess the association of agency nursing staff utilization with nursing home (NH) quality.</p><p><strong>Background: </strong>Nursing staff are the primary caregivers in NHs, where high-quality care is contingent upon their adequacy and expertise. Long-standing staffing challenges, exacerbated by the COVID-19 pandemic, have led NHs to rely on agency/contract labor to alleviate staffing shortages.</p><p><strong>Methods: </strong>This study used the following secondary datasets: Payroll-Based Journal, Care Compare: 5-Star Quality Rating System, LTCFocus.org, Area Health Resource Files, and Rural-Urban Commuting Area codes for 2017-2022. Multivariable ordinal logistic regression with 2-way (facility and year-level) fixed effects was employed. The study included all Centers for Medicare and Medicaid Services certified U.S. NHs. Analytic data comprised 80,244 facilities, averaging 13,374 unique NHs per year. The study focused on the quality star rating (1-5 scale) from the 5-Star Quality Rating System as the dependent variable. Independent variables included the proportion of agency nursing staff hours per resident day for registered nurses, licensed practical nurses, and certified nursing assistants while controlling for facility and community characteristics that may affect NH quality.</p><p><strong>Results: </strong>A 10% increase in agency registered nurses, licensed practical nurses, and certified nursing assistants (logged) was associated with a decrease in the odds of achieving a higher star rating by 4%, 5%, and 4%, respectively (P < 0.001).</p><p><strong>Conclusions: </strong>The use of agency nursing staff can negatively impact NH quality. Efforts to better integrate agency nursing staff into NHs, combined with strategies to recruit and retain permanent nursing staff, could lead to improved outcomes for residents.</p>\",\"PeriodicalId\":18364,\"journal\":{\"name\":\"Medical Care\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2024-12-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medical Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/MLR.0000000000002114\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MLR.0000000000002114","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Threads of Care: Unraveling the Impact of Agency Nursing Staff on Nursing Home Quality.
Objective: To assess the association of agency nursing staff utilization with nursing home (NH) quality.
Background: Nursing staff are the primary caregivers in NHs, where high-quality care is contingent upon their adequacy and expertise. Long-standing staffing challenges, exacerbated by the COVID-19 pandemic, have led NHs to rely on agency/contract labor to alleviate staffing shortages.
Methods: This study used the following secondary datasets: Payroll-Based Journal, Care Compare: 5-Star Quality Rating System, LTCFocus.org, Area Health Resource Files, and Rural-Urban Commuting Area codes for 2017-2022. Multivariable ordinal logistic regression with 2-way (facility and year-level) fixed effects was employed. The study included all Centers for Medicare and Medicaid Services certified U.S. NHs. Analytic data comprised 80,244 facilities, averaging 13,374 unique NHs per year. The study focused on the quality star rating (1-5 scale) from the 5-Star Quality Rating System as the dependent variable. Independent variables included the proportion of agency nursing staff hours per resident day for registered nurses, licensed practical nurses, and certified nursing assistants while controlling for facility and community characteristics that may affect NH quality.
Results: A 10% increase in agency registered nurses, licensed practical nurses, and certified nursing assistants (logged) was associated with a decrease in the odds of achieving a higher star rating by 4%, 5%, and 4%, respectively (P < 0.001).
Conclusions: The use of agency nursing staff can negatively impact NH quality. Efforts to better integrate agency nursing staff into NHs, combined with strategies to recruit and retain permanent nursing staff, could lead to improved outcomes for residents.
期刊介绍：
Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services.
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