Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-26T19:52:02.575Z Has data issue: false hasContentIssue false
  • English
  • Français

Monitoring the Outcomes of Quality of Care in Nursing Homes Using Administrative Data

Published online by Cambridge University Press:  29 November 2010

Evelyn Shapiro  and
Robert B. Tate
Evelyn Shapiro
Affiliation:
University of Manitoba
Robert B. Tate
Affiliation:
University of Manitoba
Get access Rights & Permissions [Opens in a new window]

Abstract

Routinely-collected administrative data and Cox's proportional hazards models are used to compare outcomes of care while controlling for age, sex and dependency level. The results indicate that the overall quality of nursing home care in Manitoba is good but that residents in certain regions and in certain types of nursing homes have specific outcomes that are poorer than others. These outcome indicators must not be treated as definitive signs of poorer care but as “triggers” suggesting a need for a closer look because the methodology and outcomes used in this study are still in the experimental stage. The results also indicate that secondary data provide a relatively inexpensive starting point for evaluating outcomes of nursing home care.

Résumé

Les données administratives obtenues des cueillettes de routine et les modèles de risques proportionnels de Cox sont utilisés afin de comparer les résultats de soins prodigués tout en contrôlant les effets de l'âge, du sexe et du niveau de dépendance. L'étude révèle que la qualité globale des soins prodigués dans les centres d'accueil du Manitoba est bonne, mais que dans certaines régions et dans certains types de centres d'accueil, les résultats sont moins bons chez certains résidents que chez d'autres. Ces indicateurs de résultats ne doivent pas être considérés comme des signes spécifiques de soins de moindre qualité, mais comme des «déclics» suggérant le besoin d'un examen plus approfondi, la méthodologie et les résultats utilisés dans cette étude étant encore au stade expérimental. L'étude démontre également que des données secondaires fournissent un point de départ relativement peu coûteux pour l'évaluation des résultats obtenus à la suite des soins de santé prodigués en centres d'accueil.

Keywords

OutcomesQuality of CareNursing HomesRésultatsqualité des soinscentres d'accueil
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 14 , Issue 4 , Winter/hiver 1995 , pp. 755 - 768
Copyright
Copyright © Canadian Association on Gerontology 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alison, P.D. (1985). Event history analysis, Regression for longitudinal event data. Sage University paper series 07–046, 56–57.Google Scholar
Cherry, R.L. (1991). Agents of nursing home quality of care: Ombudsmen and staff ratios revisited. The Gerontologist, 31(3), 302–308.CrossRefGoogle ScholarPubMed
Cox, D.R. (1972). Regression models and life-tables (with discussion). Journal of the Royal Statistical Society, Series B(34), 187–220.Google Scholar
DeCoster, C, Roos, N.P., & Shapiro, E. (forthcoming). Using Manitoba's Population-Based Health Information System to Assess Access to Nursing Home Care in a Single-Entry, Single-Insurer System. Canadian Journal on Aging.Google Scholar
Donabedian, A. (1966). Evaluating the quality of medical care. Milbank Memorial Fund Quarterly, 44, 166–206.CrossRefGoogle ScholarPubMed
Donabedian, A. (1980). Explorations in quality assessment and monitoring. Volume 1: the definition of quality and approaches to its assessment. Ann Arbor, MI: Health Administration Press.Google Scholar
Geron, S.M. (1991). Regulating the behavior of nursing homes through positive incentives: an analysis of Illinois' Quality Incentive Program (QUIP). The Gerontologist, 31(3), 292–301.CrossRefGoogle ScholarPubMed
Gomez, C.F. (1988). The elusive pursuit of quality in nursing homes. The Public Policy and Aging Report, 2(3), 1–9.Google Scholar
Irvine, P.W., Van Buren, N., & Crossley, K. (1984). Causes for hospitalization of nursing home residents: the role of infection. Journal of American Geriatrics Society, 32(2), 103–107.CrossRefGoogle ScholarPubMed
Kalfleisch, J.D., & Prentice, R.L. (1980). The statistical analysis of failure time data. New York: John Wiley & Sons, Inc.Google Scholar
Kane, R.A. (1988). Assessing quality in nursing homes. Clinics in Geriatric Medicine, 4(3), 655–666.CrossRefGoogle ScholarPubMed
Kane, R.L., Bell, R., Riegler, S., Wilson, A., & Kane, R.A. (1983). Assessing the outcomes of nursing-home patients. Journal of Gerontology, 38(4), 385–393.CrossRefGoogle ScholarPubMed
Linn, M.W., Gurel, L., & Linn, B.S. (1977). Patient outcome as a measure of quality of nursing home care. American Journal of Public Health, 67, 337–344.CrossRefGoogle ScholarPubMed
Phillips, C.J. (1991). Developing a method of assessing quality of care in nursing homes, using key indicators and population norms. Journal of Aging and Health, 3(3), August, 407–422.CrossRefGoogle ScholarPubMed
RoosL., Jr. L., Jr., et al. (1982). How good are the data? Reliability of one health care bank. Medical Care, 20, 266.CrossRefGoogle ScholarPubMed
Shapiro, E. (1993). Manitoba's single-entry system to long-term care. Journal of Ambulatory Care Management, 16(3), 69–74.CrossRefGoogle ScholarPubMed
Shapiro, E., & Webster, L.M. (1984). Nursing home utilization patterns for all Manitoba admission, 1974–1981. The Gerontologist, 24(6), 610–615.CrossRefGoogle ScholarPubMed
Shaughnessy, P.W., & Kramer, A.M. (1990). The increased needs of patients in nursing homes and patients receiving home health care. New England Journal of Medicine, 322, 21–7.CrossRefGoogle ScholarPubMed
Spector, W.D., & Takada, H.A. (1991). Characteristics of nursing homes that affect resident outcomes. Journal of Aging and Health, 3(4), November, 427–454.CrossRefGoogle ScholarPubMed
Thorburn, P., & Meiners, M.R. (1986). Nursing home patient outcomes: the results of an incentive reimbursement experiment. Long Term Care Studies Program Research Report, DHHS Publication No. (PHS) 86–3400. U.S. Department of Health and Human Services, National Center for Health Services Research and Health Care Technology Assessment, March.Google Scholar
Weinberg, A.D., Engingro, P.F., Miller, R.L., Weinberg, L.L., & Parker, C.L. (1989). Death in the nursing home: senescence, infection and other causes. Journal of Gerontological Nursing, 15(4), 12–16.CrossRefGoogle ScholarPubMed
Zimmerman, D., Egan, J.R., Guftason, J., et al. (1984). Evaluation of the state demonstrations in nursing home quality assurance programs. Princeton, NJ: Mathematica Policy Research, Inc.Google Scholar