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Rurality and nursing home quality: evidence from the 2004 National Nursing Home Survey.
Gerontologist. 2011 Dec; 51(6):761-73.G

Abstract

PURPOSE OF THE STUDY

To evaluate the impact of rural geographic location on nursing home quality of care in the United States.

DESIGN AND METHODS

The study used cross-sectional observational design. We obtained resident- and facility-level data from 12,507 residents in 1,174 nursing homes from the 2004 National Nursing Home Survey. We used multilevel regression models to predict risk-adjusted rates of hospitalization, influenza and pneumococcal vaccination, and moderate to severe pain while controlling for resident and facility characteristics.

RESULTS

Adjusting for covariates, residents in rural facilities were more likely to experience hospitalization (odds ratio [OR] = 1.50, 95% confidence interval [CI] = 1.16-1.94) and moderate to severe pain (OR = 1.68, 95% CI = 1.35-2.09). Significant facility-level predictors of higher quality included higher percentage of Medicaid beneficiaries, accreditation status, and special care programs. Medicare payment findings were mixed. Significant resident-level predictors included dementia diagnosis and being a "long-stay" resident.

IMPLICATIONS

Rural residents were more likely to reside in facilities without accreditations or special care programs, factors that increased their odds of receiving poorer quality of care. Policy efforts to enhance Medicare payment approaches as well as increase rural facilities' accreditation status and provision of special care programs will likely reduce quality of care disparities in facilities.

Authors+Show Affiliations

Department of Public Health and Health Sciences, University of Michigan-Flint, 2102 W.S. White Building, 303 East Kearsley Street, Flint, MI 48502-1950, USA. yukang@umich.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

21719631

Citation

Kang, Yu, et al. "Rurality and Nursing Home Quality: Evidence From the 2004 National Nursing Home Survey." The Gerontologist, vol. 51, no. 6, 2011, pp. 761-73.
Kang Y, Meng H, Miller NA. Rurality and nursing home quality: evidence from the 2004 National Nursing Home Survey. Gerontologist. 2011;51(6):761-73.
Kang, Y., Meng, H., & Miller, N. A. (2011). Rurality and nursing home quality: evidence from the 2004 National Nursing Home Survey. The Gerontologist, 51(6), 761-73. https://doi.org/10.1093/geront/gnr065
Kang Y, Meng H, Miller NA. Rurality and Nursing Home Quality: Evidence From the 2004 National Nursing Home Survey. Gerontologist. 2011;51(6):761-73. PubMed PMID: 21719631.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rurality and nursing home quality: evidence from the 2004 National Nursing Home Survey. AU - Kang,Yu, AU - Meng,Hongdao, AU - Miller,Nancy A, Y1 - 2011/06/30/ PY - 2011/7/2/entrez PY - 2011/7/2/pubmed PY - 2012/2/9/medline SP - 761 EP - 73 JF - The Gerontologist JO - Gerontologist VL - 51 IS - 6 N2 - PURPOSE OF THE STUDY: To evaluate the impact of rural geographic location on nursing home quality of care in the United States. DESIGN AND METHODS: The study used cross-sectional observational design. We obtained resident- and facility-level data from 12,507 residents in 1,174 nursing homes from the 2004 National Nursing Home Survey. We used multilevel regression models to predict risk-adjusted rates of hospitalization, influenza and pneumococcal vaccination, and moderate to severe pain while controlling for resident and facility characteristics. RESULTS: Adjusting for covariates, residents in rural facilities were more likely to experience hospitalization (odds ratio [OR] = 1.50, 95% confidence interval [CI] = 1.16-1.94) and moderate to severe pain (OR = 1.68, 95% CI = 1.35-2.09). Significant facility-level predictors of higher quality included higher percentage of Medicaid beneficiaries, accreditation status, and special care programs. Medicare payment findings were mixed. Significant resident-level predictors included dementia diagnosis and being a "long-stay" resident. IMPLICATIONS: Rural residents were more likely to reside in facilities without accreditations or special care programs, factors that increased their odds of receiving poorer quality of care. Policy efforts to enhance Medicare payment approaches as well as increase rural facilities' accreditation status and provision of special care programs will likely reduce quality of care disparities in facilities. SN - 1758-5341 UR - https://www.unboundmedicine.com/medline/citation/21719631/Rurality_and_nursing_home_quality:_evidence_from_the_2004_National_Nursing_Home_Survey_ L2 - https://academic.oup.com/gerontologist/article-lookup/doi/10.1093/geront/gnr065 DB - PRIME DP - Unbound Medicine ER -