THE EFFECT OF NURSING HOME QUALITY ON PATIENT OUTCOME.
Contributors: University Of Illinois At Chicago, Health Sciences Center.
Published: 1989
Number of pages: 192
Subjects: Health Sciences, Public Health.
Description: This historical cohort study investigated the relationship between nursing home quality and patient outcome over 6 months for 390 patients discharged to eleven nursing home. Primary outcomes of interest were mortality, rehospitalization, and discharge. For those rehospitalized, secondary outcome measures included incidence of infection, malnutrition, dehydration, and decubitus ulcer. Diagnoses at hospital discharge (ICD9-CM codes), Disease Stage (Gonnella, 1984) and age were used to control for patient factors associated with each outcome and for differences in case-mix between the nursing homes at baseline. Nursing home quality was assessed using indices from the Multiphasic Environmental Assessment Procedure (Moos and Lemke, 1984) and selected items from the Rush-Medicus Methodology for Monitoring Quality of Nursing Care. Multivariable logistic regression was used to determine if the nursing home quality indicators contribute significantly to explaining the variation in outcome when initial patient factors and case-mix differences between the homes were included in the model. Four nursing home quality indicators significantly improved the prediction of mortality: RN hours, nursing process, security and mean quality. Size of the facility was associated with a 1.4 times increased risk of rehospitalization for each additional 50 beds. Discharge was inversely associated with a diagnosis of cancer and directly associated with the nursing process score. The results support the notion that some group outcome indicators may be related to nursing home quality.
Notes: Source: Dissertation Abstracts International, Volume: 50-10, Section: B, page: 4477.

Thesis (PH.D.)--UNIVERSITY OF ILLINOIS AT CHICAGO, HEALTH SCIENCES CENTER, 1989.

School code: 0806.