Wage Mandate, Labor Turnover, and NH Quality

工资指令、劳动力流动率和 NH 质量

• 批准号: 7230986
• 负责人: Vincent Mor
• 金额: $ 36.54万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-30 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7230986
• 关键词: Accounting; Affect; Caring; Censuses; Certification; Condition; Congresses; Contracts; Data; Data Reporting; Discipline of Nursing; Doctor of Philosophy; Economics; Employment; Exercise; Expenditure; Face; Heart; Heterogeneity; Housing; Job Satisfaction; Licensing; Link; Literature; Marketing; Measures; Medicaid; Modeling; Monitor; Nurses; Nursing Homes; Nursing Models; Nursing Staff; Outcome; Patients; Perception; Performance; Platelet Factor 4; Policies; Policy Analysis; Population; Production; Productivity; Public Sector; Purpose; Quality Indicator; Quality of Care; Rate; Recommendation; Recovery; Regulation; Relative (related person); Reporting; Research Personnel; Resources; Services; Societies; Standards of Weights and Measures; Structure; Surveys; Testing; Theoretical model; Today; United States; Variant; Vulnerable Populations; Wages; Work; Workplace; cost; cost effectiveness; design; experience; insight; interest; model development; payment; pressure; programs; theories

DESCRIPTION (provided by applicant): Following a call from DHHS Secretary Tommy Thompson to Congress (3/19/2002) ASPE conducted a study on states' experiences with minimum nursing home (NH) staffing standards. The report points to the increasing need regulators have to understand the effects of wage mandates and labor turnover on NH quality. Payment structures for NHs must take into account the complexity of care today's NH population requires and the level of staff required to provide appropriate and quality care. The proposed project will examine the relationship between NH labor turnover and'retention rates, and the quality of care provided in NHs across the United States and determine how those relationships are altered in the face of state policy changes affecting staffing or wage mandates from 1999 through 2005 using data that has never before been applied to nursing home staffing issues, and informed by labor economics theory. Using the US Census Bureau's Local Employment Dynamics Data Quarterly Workforce Indicators available in 32 states, the Online Survey Certification of Automated Reporting data on nursing home structure, staffing and regulatory compliance, facility casemix acuity and resident quality indicators, and a survey of state policies, regulations and initiatives regarding NH staffing standards and wages we aim to: (1) Characterize the inter-facility, intermarket, inter-state and inter-temporal variation in staff wages, staffing ratios, and turnover (entry and exit) among nursing home staff. (2) Model the relationship between wages, turnover and retention controlling for NH direct staff contracting practices and local market labor conditions. (3) Test the impact of state policies mandating nurse staffing levels and/or wages on nursing home wages, staff turnover rates and the quality of care experienced by NH residents, controlling for market factors. (4) Test a theoretical model of nursing wages and staff turnover that characterizes the mechanisms through which state policies targeting wages and staffing ratios indirectly impact quality of services provided, through their impact on the share of more efficient workers and lower staff turnover. (5) Use the theoretical model to assess the relative merits of alternative minimum nurse staffing and wage policies in terms of their relative cost and effectiveness.

描述（由申请人提供）：DHHS秘书汤米·汤普森（Tommy Thompson）致电国会（3/19/2002）ASPE的呼吁进行了一项研究，研究了各州最低疗养院（NH）人员配备标准的经验。该报告指出，不断增长的监管机构必须了解工资授权和劳动力流动对NH质量的影响。 NHS的付款结构必须考虑到当今NH人口所需的护理的复杂性以及提供适当和优质护理所需的员工水平。拟议的项目将研究NH劳动力流动与'退休率之间的关系，以及美国NHS在NHS中提供的护理质量，并确定在面对国家政策变化时如何改变这些关系，从而影响了从1999年到2005年的人员，从1999年到2005年使用了从未应用于疗养院人员的数据，并通过经济学理论告知了这些关系。 Using the US Census Bureau's Local Employment Dynamics Data Quarterly Workforce Indicators available in 32 states, the Online Survey Certification of Automated Reporting data on nursing home structure, staffing and regulatory compliance, facility casemix acuity and resident quality indicators, and a survey of state policies, regulations and initiatives regarding NH staffing standards and wages we aim to: (1) Characterize the inter-facility, intermarket, inter-state and疗养院工作人员的员工工资，人员配备比率和营业额（入口和退出）的时间间差异。 （2）对NH直接员工承包行为和当地市场劳动条件的工资，营业额和保留控制之间的关系建模。 （3）测试规定护士人员配备水平和/或工资对疗养院工资的影响，员工营业率和NH居民经历的护理质量的影响，控制市场因素。 （4）测试一种护理工资和员工流动的理论模型，该模型特征了国家政策针对工资和人员配备比率间接影响提供服务质量的机制，并通过影响更有效的工人的份额和较低的员工营业额来影响提供的服务质量。 （5）使用理论模型根据其相对成本和有效性评估替代性最低护士人员配备和工资政策的相对优点。