| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|---|
|
|
|
|||||||
|
|||||||||
Correspondence: Address correspondence to David C. Grabowski, PhD, Assistant Professor, Department of Health Care Organization and Policy, University of Alabama at Birmingham, RPHB 330, 1665 University Boulevard, Birmingham, AL 35294-0022. E-mail: grabowsk{at}uab.edu
Purpose: We examine whether the Nursing Home Reform Act (NHRA) improved nursing home staffing and quality. Design and Methods: Data from 5,092 nursing homes were linked across the 1987 Medicare/Medicaid Automated Certification System and the 1993 Online Survey, Certification and Reporting system. A dummy-year model was used to examine the effects of the NHRA on pressure ulcers, physical restraints, and urinary catheters, and a first-difference approach to fixed-effects regression analyses was used to estimate the effects of time-varying staffing on the quality of care. Results: Overall, we found a significant increase in nursing home staffing levels from 1987 to 1993. Moreover, after controlling for other facility, resident, market, and state factors, there was a significant decrease in the proportion of residents with pressure ulcers, physical restraints, and urinary catheters following the implementation of the NHRA. Across all facilities, the increase in staffing was not directly related to the improvement in quality over the period of our study, but there was a positive relationship between registered nurse staffing and quality for facilities that were particularly deficient prior to the NHRA. Implications: Following the NHRA, quality improvements were found in nursing homes nationwide, and these results suggest that part of this improvement was due to the quality and staffing regulations within the NHRA.
Key Words: Regulation • OBRA 87 • Long-term care
This article has been cited by other articles:
|
|
 |
|
  N. G. Castle Nursing Home Caregiver Staffing Levels and Quality of Care: A Literature Review Journal of Applied Gerontology, August 1, 2008; 27(4): 375 - 405. [Abstract] [PDF]
|
|
|
|
 |
|
 J. H. Winslow and V. Borg Resources and quality of care in services for the elderly Scand J Public Health, May 1, 2008; 36(3): 272 - 278. [Abstract] [PDF]
|
|
|
|
 |
|
 E. A. Miller and V. Mor Balancing Regulatory Controls and Incentives: Toward Smarter and More Transparent Oversight in Long-Term Care Journal of Health Politics Policy and Law, January 1, 2008; 33(2): 249 - 279. [Abstract] [PDF]
|
|
|
|
 |
|
 D. C. Grabowski, A. J. O'Malley, and N. R. Barhydt The Costs And Potential Savings Associated With Nursing Home Hospitalizations Health Aff., November 1, 2007; 26(6): 1753 - 1761. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Arling, R. L. Kane, C. Mueller, J. Bershadsky, and H. B. Degenholtz Nursing Effort and Quality of Care for Nursing Home Residents Gerontologist, October 1, 2007; 47(5): 672 - 682. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. A. Kash, C. Hawes, and C. D. Phillips Comparing Staffing Levels in the Online Survey Certification and Reporting (OSCAR) System With the Medicaid Cost Report Data: Are Differences Systematic? Gerontologist, August 1, 2007; 47(4): 480 - 489. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Putnam, Fengyan Tang, A. Brooks-Danso, J. Pickard, and N. Morrow-Howell Professionals' Beliefs About Nursing Home Regulations in Missouri Journal of Applied Gerontology, June 1, 2007; 26(3): 290 - 304. [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]
|
|
|
|
|
|
P. Stolee, J. Esbaugh, S. Aylward, T. Cathers, D. P. Harvey, L. M. Hillier, N. Keat, and J. W. Feightner Factors Associated With the Effectiveness of Continuing Education in Long-Term Care Gerontologist, June 1, 2005; 45(3): 399 - 409. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. Schnelle Determining the Relationship Between Staffing and Quality Gerontologist, February 1, 2004; 44(1): 10 - 12. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|---|
| All GSA journals | Journals of Gerontology Series A: Biological Sciences and Medical Sciences | Journals of Gerontology Series B: Psychological Sciences and Social Sciences |
