Pilonieta G.
Abstract
Objective: To evaluate the effects of adopting AD SCUs on nursing homes’ processes (use of physical restraints, antipsychotic drugs, and use of feeding tubes) and residents’ outcomes (proportion of long-stay residents with pressure ulcers, proportion of long-stay residents who have fallen, and hospitalization rate) measures of quality of care. Data Sources: This study utilized data from three different sources: Brown University’s LTCFocus data, Online Survey, Certification, and Reporting (OSCAR) and Certification and Survey Provider Enhanced Reporting (CASPER), and the Area Health Resource File from 2006 to 2018. The sample consists of approximately 148,707 nursing home-year observations over the 13-year study period. This sample included a national population of Medicare and Medicaid-certified nursing homes that are categorized as nongovernment not-for-profit or investor-owned for-profit facilities. Study Design: We performed panel data linear regressions with facility fixed effects and year fixed effects to estimate the effects of AD SCUs on each of the dependent variables controlling for a range of organizational and market covariates. Principal Findings: Facilities that adopted AD SCUs had a lower prevalence of feeding tubes, pressure ulcers, and hospitalizations among nursing home residents. Furthermore, a higher percentage of AD SCU beds resulted in a marginal decrease in physical restraints. Conclusions: Our findings suggest differences in care processes and outcomes associated with AD SCUs adoption, such as reducing physical restraints, feeding tubes, pressure ulcers, and hospitalization rates. These findings will provide policymakers and nursing home administrators with a better understanding of quality nursing care and the relationship between AD SCUs and NHs' quality of care.