Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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Public Reporting on the Quality Ratings of Nursing Homes in the Republic of Korea

  • Lee, Hyang Yuol (Research Institute of Nursing Science, College of Nursing, Seoul National University) ;
  • Shin, Juh Hyun (College of Nursing, Ewha Womans University)
  • Received : 2018.10.17
  • Accepted : 2019.02.08
  • Published : 2019.04.30
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Abstract

Background: Quality ratings could provide vital information to help people in choosing a nursing home. Purpose: This study investigated factors aligned with quality ratings of nursing homes. Methods: We employed a cross-sectional descriptive design to assess publicly available data on 1,354 nursing homes with 30 or more beds in the Republic of Korea. After excluding 289 nursing homes with no reported quality-evaluation ratings, we analyzed the 2015 data of 1,065 nursing homes. To prevent multicollinearity among independent variables, we carefully selected the final set of variables based on clinical and theoretical meaningfulness to direct nursing care. Quality, the ordinal outcome, was scored from 1 to 5 with a higher score indicating higher quality of the organization. We constructed a multivariate ordered logistic regression model. Results: Higher quality ratings of nursing homes was significantly related to the number of unoccupied beds (OR=0.99, p=.024), registered nurses (RNs) (OR=1.30, p=.003), qualified care workers (OR=1.03, p=.011), cognitive-improvement programs (OR=1.05, p=.024), and other programs for residents' activities (OR=1.09, p<.001). Conclusion: The number of RNs had the strongest influence on the publicly reported quality rating, while the rating of qualified care workers demonstrated little effect and that of nursing assistants had no effect. The number of RNs could be used as a crucial indicator for high-quality homes; more resident-engaging programs also demonstrated better quality of nursing home care.

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References

  1. Marshall MN, Shekelle PG, Leatherman S, Brook RH. The public release of performance data: What do we expect to gain? A review of the evidence. JAMA. 2000;283(14):1866-1874. https://doi.org/10.1001/jama.283.14.1866
  2. Werner RM, Konetzka RT, Kim MM. Quality improvement under nursing home compare: The association between changes in process and outcome measures. Medical Care. 2013;51(7):582-588. https://doi.org/10.1097/MLR.0b013e31828dbae4
  3. Werner R, Stuart E, Polsky D. Public reporting drove quality gains at nursing homes. Health Affairs (Millwood). 2010;29(9):1706-1713. https://doi.org/10.1377/hlthaff.2009.0556
  4. Werner RM, Konetzka RT, Stuart EA, Polsky D. Changes in patient sorting to nursing homes under public reporting: Improved patient matching or provider gaming? Health Services Research. 2011;46(2):555-571. https://doi.org/10.1111/j.1475-6773.2010.01205.x
  5. Herr A, Nguyen TV, Schmitz H. Public reporting and the quality of care of German nursing homes. Health Policy. 2016;120(10):1162-1170. https://doi.org/10.1016/j.healthpol.2016.09.004
  6. National Health Insurance Service. Long-term care agency evaluation manual [Internet]. Wonju: National Health Insurance Service; c2015 [cited 2015 Jan 30]. Available from: http://www.longtermcare.or.kr/npbs/d/m/000/moveBoard-View?menuId=npe0000000770&bKey=B0009&search_boar-dId=50502.
  7. National Health Insurance Service. Long term care insurance [Internet]. Wonju: National Health Insurance Service; c2018 [cited 2018 Sep 13]. Available from: http://www.longtermcare.or.kr/npbs/e/b/101/npeb101m01.web?q=C1010767189E0082F8B- 44831F6641647929078B842F2C3;s0ugjCW7oDVzaA2ZbGcyR4soShLbQgBUT3TCe7QhUCNRsZYo0cfyiKXeTb0gW9aN1YFUugGBRTKOuWxSDvykZA%3D%3D;aNIlpWJiykO3I0XR9hGe3bnwuFs% 3D&charset=UTF-8.
  8. Seon WD. Analysis of installation status of long-term care facilities for the elderly and political implication. Health.Welfare Issue & Focus. 2015;299:1-8.
  9. National Health Insurance Service. Long term care insurance. Wonju: National Health Insurance Service; c2011 [cited 2018 Oct 15]. Available from: http://www.longtermcare.or.kr/npbs/.
  10. Kim H, Kwon S, Yoon NH, Hyun KR. Utilization of long-term care services under the public long-term care insurance program in Korea: Implications of a subsidy policy. Health Policy. 2013;111(2):166-174. https://doi.org/10.1016/j.healthpol.2013.04.009
  11. National Health Insurance Service. Long-term care agency evaluation plan and major changes [Internet]. Wonju: National Health Insurance Service; c2015 [cited 2015 Jan 30]. Available from: http://www.longtermcare.or.kr/npbs/d/m/000/move-BoardView?menuId=npe0000000770&bKey=B0009&search_boardId=50502.
  12. National Health Insurance Service. The evaluation result of 2015 long term care insurance [Internet]. Wonju: National Health Insurance Service; c2016 [cited 2016 Apr 22]. Available from: http://www.longtermcare.or.kr/npbs/d/m/000/moveBoardView?menuId=npe0000000770&bKey=B0009&-search_boardId=60016.
  13. National Health Insurance Service. Long-term care agency (facility benefit) periodic evaluation plan [Internet]. Wonju: National Health Insurance Service; c2018 [cited 2018 Sep 13]. Available from: http://www.longtermcare.or.kr/npbs/d/m/000/moveBoardView?menuId=npe0000000770&bKey=B0009&-search_boardId=60016.
  14. Ha HS. Evaluation for long-term care for the elderly [Internet]. Seoul: National Assembly Budget Office; c2015 [cited 2015 Sep 14]. Available from: https://www.nabo.go.kr/Sub/01Report/01_01_Board.jsp?funcSUB=view&bid=19&arg_cid1=0&arg_cid2=0&arg_class_id=0 curentPage=0&pageSize=10&curentPageSUB=0&pageSizeSUB=10&key_typeSUB=subject&keySUB=%EC%9E%A5%EA%B8%B0%EC%9A%94%EC%96%91&search_start_dateSUB=&search_end_dateSUB=&department=0&department_sub=0&etc_cate1=&etc_cate2=&sortBy=reg_date&ascOrDesc=-desc&search_key1=&etc_1=0&etc_2=0&tag_key=&arg_id=5622&item_id=5622&etc_1=0&etc_2=0&name2=0.
  15. Yoo J. How the change in the evaluation policy affects the grade, closure, and reinstallation of long-term care facilities? Health and Social Welfare Review. 2017;37(4):71-97. https://doi.org/10.15709/hswr.2017.37.4.71
  16. Medicare.gov. About nursing home compare data [Internet]. Lawrence: Medicare.gov; c2018 [cited 2018 Jun 5]. Available from: https://www.medicare.gov/nursinghomecompare/Data/About.html#dataSource.
  17. Mukamel DB, Weimer DL, Spector WD, Ladd H, Zinn JS. Publication of quality report cards and trends in reported quality measures in nursing homes. Health Service Research. 2008;43(4):1244-1262. https://doi.org/10.1111/j.1475-6773.2007.00829.x
  18. Grabowski DC, Town RJ. Does information matter? Competition, quality, and the impact of nursing home report cards. Health Services Research. 2011;46(6pt1):1698-1719. https://doi.org/10.1111/j.1475-6773.2011.01298.x
  19. Huang SS, Hirth RA. Quality rating and private-prices: Evidence from the nursing home industry. Journal of Health Economics. 2016;50:59-70. https://doi.org/10.1016/j.jhealeco.2016.08.007
  20. Polit DF. Data analysis and statistics for nursing research. Upper Saddle River (NJ): Appleton & Lange; 1996. p. 281-284.
  21. American Nurses Association (ANA). Safe staffing [Internet]. Silver Spring (MD): ANA; c2015-2018 [cited 2018 Oct 6] Available from: https://ana.aristotle.com/SitePages/safestaffing.aspx.
  22. Kjos BO, Havig AK. An examination of quality of care in Norwegian nursing homes - a change to more activities? Scandinavian Journal of Caring Sciences. 2016;30(2):330-339. https://doi.org/10.1111/scs.12249
  23. Shin JH. Relationship between nursing staffing and quality of life in nursing homes. Contemporary Nurse. 2013;44(2):133-143. https://doi.org/10.5172/conu.2013.44.2.133
  24. Shin JH, Hyun TK. Nurse staffing and quality of care of nursing home residents in Korea. Journal of Nursing Scholarship. 2015;47(6):555-564. https://doi.org/10.1111/jnu.12166
  25. Lee HY, Blegen MA, Harrington C. The effects of RN staffing hours on nursing home quality: A two-stage model. International Journal of Nursing Studies. 2014;51(3):409-417. https://doi.org/10.1016/j.ijnurstu.2013.10.007
  26. Korea Ministry of Government Legislation. Long term care insurance law [Internet]. Sejong: Korea Ministry of Government Legislation; c2019 [cited 2018 Sep 14]. Available from: http://www.law.go.kr/lsSc.do?tabMenuId=tab18&query=%EB%85%B8%EC%9D%B8%EC%9E%A5%EA%B8%B0%EC%9A%94%EC%96%91%EB%B3%B4%ED%97%98%EB%B2%95#undefined.
  27. Min A, Park CG, Scott LD. Evaluating technical efficiency of nursing care using data envelopment analysis and multilevel modeling. Western Journal of Nursing Research. 2016:38(11):1489-1508. https://doi.org/10.1177/0193945916650199
  28. Ma C, Olds DM, Dunton NE. Nurse work environment and quality of care by unit types: A cross-sectional study. International Journal of Nursing Studies. 2015;52(10):1565-1572. https://doi.org/10.1016/j.ijnurstu.2015.05.011
  29. He D, Konetzka RT. Public reporting and demand rationing: Evidence from the nursing home industry. Health Economics. 2015;24(11):1437-1451. https://doi.org/10.1002/hec.3097
  30. Hefele JG, Acevedo A, Nsiah-Jefferson L, Bishop C, Abbas Y, Damien E, et al. Choosing a nursing home: What do consumers want to know, and do preferences vary across race/ethnicity? Health Research and Educational Trust. 2016;51 Suppl 2:1167-1187. https://doi.org/10.1111/1475-6773.12457
  31. Groenewoud AS, van Exel NJA, Berg M, Huijsman R. Building quality report cards for geriatric care in the Netherlands: Using concept mapping to identify the appropriate "building blocks" from the consumer's perspective. The Gerontologist. 2008;48(1):79-92. https://doi.org/10.1093/geront/48.1.79
  32. Pesis-Katz I, Phelps CE, Temkin-Greener H, Spector WD, Veazie P, Mukamel DB. Making difficult decisions: The role of quality of care in choosing a nursing home. American Journal of Public Health. 2013;103(5):e31-e37. https://doi.org/10.2105/AJPH.2013.301243

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