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http://dx.doi.org/10.4040/jkan.2019.49.2.161

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)
Publication Information
Journal of Korean Academy of Nursing / v.49, no.2, 2019 , pp. 161-170 More about this Journal
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.
Keywords
Korea; Nursing Homes; Quality of Health Care; Annual Report;
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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   DOI
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   DOI
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   DOI
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   DOI
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   DOI
6 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/.
7 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.
8 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.
9 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.
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   DOI
11 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.
12 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.
13 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.
14 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.
15 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.
16 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   DOI
17 Polit DF. Data analysis and statistics for nursing research. Upper Saddle River (NJ): Appleton & Lange; 1996. p. 281-284.
18 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   DOI
19 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   DOI
20 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   DOI
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   DOI
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   DOI
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   DOI
25 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   DOI
26 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   DOI
27 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.
28 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   DOI
29 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   DOI
30 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   DOI
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   DOI
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   DOI