期刊
JOURNAL OF AGING AND HEALTH
卷 15, 期 2, 页码 295-331出版社
SAGE PUBLICATIONS INC
DOI: 10.1177/0898264303015002001
关键词
ambulatory care-sensitive hospitalizations
资金
- AHRQ HHS [1 R01 HS075767-01A1] Funding Source: Medline
- NIA NIH HHS [AG00198-10] Funding Source: Medline
- PHS HHS [30-P91009/01] Funding Source: Medline
Objectives: This study examined patient-level, facility-level, and area market-level factors affecting ambulatory care-sensitive hospitalization (ACSH) rates among nursing home residents. Although ACSH has long been used to monitor accessibility to health care services among community-dwelling populations, the use of ACSH rates as an indicator of potential quality-of-care problems affecting nursing home residents has not been employed. Methods: Three years of quarterly Medicaid reimbursement data from more than 500 nursing homes were linked to 4 years of Medicare Provider Analysis and Review hospital claims data, nursing facility attribute data, and Area Resource File data to investigate the relative contribution of patient-, facility-, and market-level risk factors to ACSH among nursing home residents. Results: Logistic regression:results indicate that facility-level factors and nursing home quality-of-care indicators significantly contribute to. the risk of ACSH. Discussion: Findings underscore the need for continuing efforts to improve quality-of-care practices in nursing homes, particularly with respect to associations between quality-of-care indicators and facility structural/organizational characteristics with ACSHs.
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