Nursing Homes: Measuring Care Orientation and Quality

疗养院：衡量护理方向和质量

• 批准号: 7088653
• 负责人: BITA Arbab KASH
• 金额: $ 3万
• 依托单位: TEXAS A&M UNIVERSITY HEALTH SCIENCE CTR
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-01-17 至 2006-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7088653
• 关键词: clinical research; decision making; health care cost /financing; health care facility; health care model; health care personnel; health care policy; health care quality; health care service evaluation; health disparity; health services research tag; human data; model design /development; nursing homes; racial /ethnic difference

DESCRIPTION (provided by applicant): This proposed study will explore the effect of nursing home spending patterns on quality of care, staff mix and staff turnover by using financial ratio analysis methods. Analysis of financial ratios is one of the most effective and widely used methods of evaluating management behavior and strategic orientation. Financial ratio analysis has been traditionally used by creditors, stockholders, and top-level management decision makers in order to predict future conditions of a firm and to make plans that will influence the future course of events, including quality improvements. Studies on nursing home quality have only examined the effects of broad organizational factors such as profit status, profit margin, and total resident care cost on a number of quality indicators. The applicant proposes an analytical approach that will identify and examine specific financial ratios that help produce higher levels of quality by disaggregating total spending into a number of cost centers and activities. This new approach will clarify the effect of a facility's allocation of spending among different cost categories on a variety of quality indicators. Data sources include the Texas Medicaid Cost Report Data, a multidimensional set of quality indicators from the Minimum Data Set (MDS) and Online Survey Certification Automated Reporting (OSCAR) data sets, and market variables from the Area Resource File (ARF). These data will be used to develop a set of structure, process and outcome quality measures, including staff mix and staff turnover. The analysis will focus on the effect of financial ratios, controlling for market factors, on quality. In addition to the individual financial ratios, the applicant will evaluate the utility of a financial ratio scale as a predictor of quality. Furthermore, this study will explore racial and socioeconomic disparities in nursing homes. In order to improve nursing home quality, regulatory and payment policy must establish an incentive structure for practices that result in changes in the way the majority of facilities currently perform. Results from this study could identify limits on administrative costs or minimum direct resident care spending levels that suggest a more effective reimbursement structure. Such spending guidelines and changes in payment policy, combined with incentives for better staff mix and retention, might be more effective policy tools affecting nursing home management decisions than the poorly enforced federal minimum quality standards.

描述（由申请人提供）：这项拟议的研究将探讨疗养院支出模式对使用财务比率分析方法的护理质量，员工组合和员工流动质量的影响。财务比率分析是评估管理行为和战略取向的最有效和广泛使用的方法之一。传统上，债权人，股东和顶级管理决策者一直使用财务比率分析，以预测公司的未来状况并制定计划，以影响未来的事件，包括质量改进。关于疗养院质量的研究仅研究了广泛的组织因素的影响，例如利润状况，利润率和居民总护理成本对许多质量指标的影响。申请人提出了一种分析方法，该方法将识别和检查特定的财务比率，通过将总支出分解为许多成本中心和活动，从而有助于产生更高水平的质量。这种新方法将阐明设施在不同成本类别之间支出分配对各种质量指标的影响。数据源包括德克萨斯州医疗补助成本报告数据，最低数据集（MDS）和在线调查认证自动报告（OSCAR）数据集（OSCAR）数据集的多维质量指标以及来自区域资源文件（ARF）的市场变量。这些数据将用于制定一组结构，过程和结果质量措施，包括员工组合和员工流动。该分析将集中于财务比率，控制市场因素，对质量的影响。除了个人财务比率外，申请人还将评估财务比率量表的效用作为质量的预测指标。此外，这项研究将探索疗养院中的种族和社会经济差异。为了提高疗养院的质量，监管和支付政策必须建立一种激励结构，以导致大多数设施的运作方式变化。这项研究的结果可以确定行政成本或最低直接居民护理支出水平的限制，这表明更有效的报销结构。这种支出准则和付款政策的变化，加上更好的员工组合和保留率的激励措施，可能是影响疗养院管理决策的更有效的政策工具，而不是执行不良的联邦最低质量标准。

项目成果

Nursing home spending, staffing, and turnover.

疗养院支出、人员配备和营业额。

• DOI: 10.1097/01.hmr.0000281625.20740.13
• 发表时间: 2007
• 期刊: Health care management review
• 影响因子: 2.5
• 作者: Kash,BitaA;Castle,NicholasG;Phillips,CharlesD
• 通讯作者: Phillips,CharlesD

Advertising expenditures in the nursing home sector: evaluating the need for and purpose of advertising.

疗养院行业的广告支出：评估广告的需求和目的。

• 发表时间: 2008
• 期刊: Journal of healthcare management / American College of Healthcare Executives
• 作者: Kash,BitaA;Boyer,GregoryJ
• 通讯作者: Boyer,GregoryJ