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Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309036461
Category : Medical
Languages : en
Pages : 432
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Book Description
As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309036461
Category : Medical
Languages : en
Pages : 432
Get Book Here
Book Description
As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309036437
Category : Medical
Languages : en
Pages : 580
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Book Description
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309175704
Category : Medical
Languages : en
Pages : 558
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Book Description
Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309132746
Category : Medical
Languages : en
Pages : 344
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Book Description
Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
Author: Brenda Lewis Cleary, PhD, RN, FAAN
Publisher: Springer Publishing Company
ISBN: 0826118968
Category : Medical
Languages : en
Pages : 135
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Book Description
Winner of an AJN Book of the Year Award! Nursing homes are rich repositories of data, yet are underutilized for controlled research studies. This book is a hands-on guide to conducting long-term care research in both nursing homes and home care settings. It offers an overview of possible research in the field along with practical information on how to gain access to and work with complex institutions that may not welcome change. The author also suggests the most effective research methodology for long-term care settings, and how to implement and disseminate successful research.
Author: United States. Congress. House. Committee on Interstate and Foreign Commerce. Subcommittee on Health and the Environment
Publisher:
ISBN:
Category : Home care services
Languages : en
Pages : 34
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Book Description
Author: United States. Health Professions Education and Manpower Training Bureau
Publisher:
ISBN:
Category :
Languages : en
Pages : 64
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Book Description
Author: Metin Baki
Publisher: GRIN Verlag
ISBN: 3346292029
Category : Medical
Languages : en
Pages : 61
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Book Description
Master's Thesis from the year 2020 in the subject Health - Nursing Science - Nursing Management, grade: 1.0, , language: English, abstract: The focus of this paper was to identify factors that increase the probability of COVID-19 cases in nursing homes and to provide an exemplary concept for the application of the findings using machine learning algorithms to allow future research to derive appropriate countermeasures in practice. The findings are based on 13,069 US nursing homes, and the results are mostly consistent with most recent studies around this topic. Thus, this study provides not only additional evidence for previously studied factors based on a larger population of nursing homes with a holistic approach but also complements these with features not yet examined, such as most importantly the competitive environment of a nursing home. The findings show evidence of a relationship between COVID-19 infections and fatalities and (1) the size of a nursing home, (2) a facility's age, (3) whether a nursing home is for-profit, (4) whether a nursing home is urban or rural, (5) the number of federal deficiencies, (6) the total amount of fines, (7) the concentration of residents with Medicaid, (8) the share of residents from a racial or ethnic minority, (9) the excess of beds in the respective county of a nursing home, (10) the number of infections per 100,000 people in a county, and (11) the number of deaths per 100,000 people in a county, (12) the occupancy rate, (13) the overall CMS facility rating, (14) the total reported RN staffing levels, (15) the total reported nurse staffing levels and (16) the Herfindahl Index.
Author: Laurence Z. Rubenstein
Publisher: SAGE
ISBN: 0803943075
Category : Medical
Languages : en
Pages : 361
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Book Description
This volume provides systematic reviews of the state of clinical and health services research, in particular patient-care problem areas pertinent to nursing homes. Each chapter defines progress on a specific nursing home clinical problem and provides a critical synthesis and review of research information. Topics covered include: medication use; infection control; pressure ulcers; falls; urinary incontinence; and behavioural problems.
Author: Yuliana Levchenko
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
Aging is an inevitable process that brings about changes in health and increases the risk of degenerative health conditions and mortality, posing significant challenges to public health (Betteridge 2000; Harman 1991). The demographics of the United States are changing rapidly, with a larger proportion of the population now being over the age of 65. This demographic shift, often referred to as the "aging population" or "Silver Tsunami," has raised concerns about the long-term financial sustainability of social safety net programs like Medicare and Social Security. As the number of older adults continues to grow, the strain on these programs is increasing, and policymakers are grappling with the need to find sustainable solutions to address the fiscal challenges associated with population aging (Frank and Neuman 2021; Getzen 1992; Mitchell 2014). Nursing homes, which provide care for individuals with conditions requiring constant supervision, account for a substantial portion of public spending. As the population ages, the demand for long-term care services, including skilled nursing home care, is expected to rise significantly. This has prompted policymakers and public health researchers to explore strategies aimed at reducing utilization and costs in nursing homes, while maintaining the quality of care for older adults (Colello 2018; Wunderlich and Kohler 2001). Drawing upon data from the Health and Retirement Study (HRS) spanning from 2000 to 2018, my research centers on investigating the social determinants of nursing home admission. Specifically, I examine the impact of factors such as caregiving intensity, underlying care need, home modifications, and race on the risk of nursing home admission. To provide a solid foundation for my work, I have incorporated two theoretical frameworks, namely successful aging, and aging in place. These frameworks highlight the significance of maintaining physical health, cognitive function, and social connections while living independently in one's preferred environment. By delving into the factors that influence nursing home admission, my research aims to enhance our understanding of how older adults can sustain their independence and quality of life as they age (Annele, Satu, and Timo 2019; Rowe and Kahn 1997; Wiles et al. 2012). Caregiving is crucial in supporting older adults in aging in place, allowing them to remain in their preferred living environment while maintaining their independence and quality of life. Caregivers provide various types of support, including assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs), emotional support, and companionship. Adequate caregiving support enables older adults to continue living at home, maintain their physical and cognitive health, and participate in their community (Schulz and Eden 2016). In Chapter 1, I examine the association between receiving care and the risk of nursing home admission. The key findings of chapter 1 show that higher levels of care receipt and living alone increase the risk of being admitted to a nursing home. The findings suggest that individuals who require more intensive care and report unmet care needs are at a higher risk of being admitted to nursing homes. Interestingly, black individuals exhibit a lower risk of nursing home admission, which may be attributed to cultural and social factors, stronger informal support networks, and greater financial or geographic obstacles to accessing skilled nursing care. Furthermore, the study identifies living alone as a significant risk factor for nursing home admission, underscoring the importance of social support and companionship for older adults. These findings provide valuable insights into the complex and multifaceted factors that influence the risk of nursing home admission among older adults. Home modifications also play a crucial role in supporting older adults in aging in place successfully. These modifications involve making changes to the home environment to make it safer, more accessible, and more conducive to the needs of older adults. Home modifications can include installing grab bars, handrails, ramps, and other safety features, as well as making changes to the layout or design of the home to accommodate mobility challenges or other physical limitations. To further investigate potential interventions to reduce nursing home utilization, Chapter 2 examines the effect of home modification measures, such as ramps, railings, wheelchairs, grab bars/shower seats, and call systems, on nursing home admission. These interventions aim to improve accessibility and may have implications for aggregate health outcomes and healthcare spending, as nursing home care is primarily covered by Medicaid and out-of-pocket expenses (Colello 2018). To summarize the key findings from chapter 2 of my dissertation, call systems have different effects on admission risk depending on subgroup characteristics. On the other hand, grab bars and shower seats are consistently associated with a reduced risk of admission across all subgroups. This chapter also find that ramps and railings are not significant predictors of admission risk, and the impact of wheelchair modifications on admission risk is inconsistent. The findings indicate grab bars and shower seats are potentially promising interventions for reducing the risk of nursing home admission, regardless of subgroup characteristics, while highlighting the need for further investigation into the effectiveness of home modifications in reducing admission risk among older adults. Chapter 3 of my dissertation explores how race affects the risk of nursing home admission. To do this, I estimate three types of models: a traditional Cox proportional-hazards model, a cause-specific Cox model, and a Fine-Gray model. Through these analyses, I investigate the relationship between race and nursing home admission, taking into consideration the impact of death as an informative competing event. Based on the findings presented in Chapter 3, it is evident that Black individuals consistently exhibit a lower hazard ratio of nursing home admission compared to Whites, as evidenced by the consistently lower admission rates across all three models. However, it is important to note that the impact of race on admission risk changes when death is included as an informative censoring mechanism, indicating the need for appropriate adjustment in the analysis. While death may contribute to the differential in nursing home admission between Black and White individuals, it alone does not fully explain the observed racial disparity in nursing home admission. The analysis suggests that multiple factors may contribute to this disparity, including health status, socioeconomic status, access to care, family caregiving, residential segregation, and discrimination. These factors may interact in complex ways, resulting in differential utilization of nursing home care among older Black and White adults. The research on nursing home admission conducted in my dissertation expands upon existing literature by examining how social determinants of health impact the risk of nursing home admission among older adults. The findings of this study have important implications for policy initiatives aimed at improving the quality of care for older adults and promoting aging in place. One significant recommendation that arises from this research is the promotion of community-based programs, home-based services, and the subsidization of home modifications, specifically grab bars and shower seats. These initiatives can offer support and resources to older adults and their families, allowing them to continue living in their chosen place for as long as possible. Addressing social determinants of health, including socioeconomic status, access to care, and residential segregation, can significantly impact the prevention of nursing home admission among older adults. Implementation of policies that target these determinants, such as improving access to affordable healthcare, reducing socioeconomic disparities, and promoting inclusive and age-friendly communities, can create an enabling environment that supports older adults in aging in place and remaining in their homes.
