Trends and Predictors of Quality of Care in VA Nursing Homes Related to Serious Mental Illness
Bibliographic Data
| ID | 9097019 |
|---|---|
| Authors | Hyungjin Myra Kim (0000-0002-0604-8027, Statistical Research (United States), corresponding author), Jane Banaszak-Holl (0000-0002-6896-600X, Government of Western Australia Department of Health), Helen Kales, Helen C Kales (0000-0002-2032-370X, University of Michigan), Jennifer Mach (0000-0002-3695-9980), Fred Blow (University of Michigan), John F Mccarthy (0000-0002-2560-5917, University of Michigan) |
| Year | 2013 |
| Volume | 51 |
| Issue | 8 |
| Pages | 659-665 |
| Publication date | 2013-08-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0b013e318293c28d |
| PMID | 23632596 |
| OpenAlex | W2069619213 |
| Language | EN |
| References cited | 8 |
OBJECTIVE: Within Veterans Affairs (VA) nursing homes (NHs), quality issues have a tremendous impact on the population with serious mental illness (SMI), who are more likely than their non-SMI Veteran counterparts to use NH services. We examined recent trends in quality indicators (QIs) measuring poor performance of VA NHs and whether the facility-level QIs vary with SMI concentration within the facility. METHODS: From VA administrative records including Minimum Data Set assessments, we identified all residents in the 135 VA NHs between fiscal years 2005 (FY05) through FY07. We used a zero-inflated Poisson regression to assess trends in and facility-level predictors of 3 process-related QIs: depression without antidepressant therapy; bladder/bowel incontinence without a toileting plan; and physical restraint use. Facility-level predictors included collocated special care units, rurality, staffing, physical plant characteristics, SMI prevalence, and SMI admission volume. RESULTS: During FY05-FY07, restraint use declined from 1.2% to 1.1% and incontinence without a toileting plan from 25.8% to 22.1%, but untreated depression increased from 5.1% to 5.5%. Despite overall gains in quality, higher SMI prevalence was associated with higher odds of physical restraint use and lack of toileting plan. Higher SMI prevalence was also associated with higher frequency of untreated depression. Other characteristics such as complex building structure were predictive of variation in quality, but the relationships were not consistent across QI types. CONCLUSION: VA NHs had significant improvements in these examined QIs during the study period. Nonetheless, overall poorer quality was observed at sites with higher SMI concentrations
Activities of daily living · Depression (economics) · Environmental health · Logistic regression · Mental health · Mental illness · Minimum Data Set · Nursing homes · Odds · Poisson regression · Population · Psychiatry · Staffing · Toileting · Veterans Affairs · Geriatric Care and Nursing Homes · Healthcare Decision-Making and Restraints · Internal Medicine · Medicine · Nursing · Schizophrenia research and treatment · Gerontology
Likelihood Ratio Tests for Model Selection and Non-Nested Hypotheses
Caregiver Staffing in Nursing Homes and Their Influence on Quality of Care
Achieving Consensus Across Diverse Stakeholders on Quality Measures for Mental Healthcare
Risk of Nursing Home Admission in Association With Mental Illness Nationally in the Department of Veterans Affairs
| Citation velocity | historical |
|---|---|
| Highly cited | No |