Rurality and Nursing Home Quality: Evidence from the 2004 National Nursing Home Survey

Autor/inn/en	Kang, Yu; Meng, Hongdao; Miller, Nancy A.
Titel	Rurality and Nursing Home Quality: Evidence from the 2004 National Nursing Home Survey
Quelle	In: Gerontologist, 51 (2011) 6, S.761-773 (13 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0016-9013
DOI	10.1093/geront/gnr065
Schlagwörter	Nursing Homes; Rural Population; Geographic Location; Institutional Characteristics; National Surveys; Health Services; Accreditation (Institutions); Pain; Institutionalized Persons + Suchen Sie Ihr Suchwort? Sonderheim; Landbevölkerung; Health service; Gesundheitsdienst; Gesundheitswesen; Accreditation; Institution; Institutions; Akkreditierung; Staatliche Anerkennung; Institut; Schmerz
Abstract	Purpose of the Study: To evaluate the impact of rural geographic location on nursing home quality of care in the United States. Design and Methods: The study used cross-sectional observational design. We obtained resident- and facility-level data from 12,507 residents in 1,174 nursing homes from the 2004 National Nursing Home Survey. We used multilevel regression models to predict risk-adjusted rates of hospitalization, influenza and pneumococcal vaccination, and moderate to severe pain while controlling for resident and facility characteristics. Results: Adjusting for covariates, residents in rural facilities were more likely to experience hospitalization (odds ratio [OR] = 1.50, 95% confidence interval [CI] = 1.16-1.94) and moderate to severe pain (OR = 1.68, 95% CI = 1.35-2.09). Significant facility-level predictors of higher quality included higher percentage of Medicaid beneficiaries, accreditation status, and special care programs. Medicare payment findings were mixed. Significant resident-level predictors included dementia diagnosis and being a "long-stay" resident. Implications: Rural residents were more likely to reside in facilities without accreditations or special care programs, factors that increased their odds of receiving poorer quality of care. Policy efforts to enhance Medicare payment approaches as well as increase rural facilities' accreditation status and provision of special care programs will likely reduce quality of care disparities in facilities. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10