National Healthcare Quality and Disparities Report
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- Disparities (1)
- Elderly (2)
- Healthcare-Associated Infections (HAIs) (1)
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- Nursing Homes (2)
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- (-) Pressure Ulcers (4)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 4 of 4 Research Studies DisplayedSanghavi P, Chen Z
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
The purpose of this study was to evaluate the relationship between nursing home characteristics and reporting of 2 of 3 specific clinical outcomes reported by the Nursing Home Care Compare (NHCC) website: major injury falls and pressure ulcers. The researchers of this quality improvement study utilized hospitalization data for all Medicare fee-for-service beneficiaries between January 1, 2011, and December 31, 2017. Hospital admission claims for major injury falls and pressure ulcers were linked with facility-reported evaluations at the nursing home resident level. For each linked hospital claim, it was determined whether the nursing home had reported the event and rates of reporting were computed. To evaluate whether nursing homes reported similarly on both measures, the researchers estimated the relationship between reporting of major injury falls and pressure ulcers within a nursing home, and explored racial and ethnic disparities that could otherwise explain the associations. The study sample included 13,179 nursing homes where 131,000 residents experienced major injury fall or pressure ulcer hospitalizations. Of the 98,669 major injury fall hospitalizations, 60.0% were reported, and of the 39,894 stage 3 or 4 pressure ulcer hospitalizations, 67.7% were reported. Underreporting for both conditions was pervasive, with 69.9% and 71.7% of nursing homes having reporting rates less than 80% for major injury fall and pressure ulcer hospitalizations, respectively. Lower reporting rates had few correlations with facility characteristics other than racial and ethnic composition. Facilities with high vs low fall reporting rates had significantly more White residents (86.9% vs 73.3%), and facilities with high vs low pressure ulcer reporting rates had significantly fewer White residents (69.7% vs 74.9%).
AHRQ-funded; HS026957.
Citation: Sanghavi P, Chen Z .
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
JAMA Netw Open 2023 May; 6(5):e2314822. doi: 10.1001/jamanetworkopen.2023.14822..
Keywords: Quality Measures, Quality of Care, Elderly, Disparities, Racial and Ethnic Minorities, Nursing Homes, Pressure Ulcers, Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Long-Term Care
Chen Z, Gleason LJ, Sanghavi P
Accuracy of pressure ulcer events in US nursing home ratings.
This study investigated the accuracy of the government website Nursing Home Compare (NHC) pressure ulcer measures, which are chief indicators of nursing home patient safety. The authors identified hospital admissions for pressure ulcers and linked them to the nursing home-reported data at the patient level using Medicare fee-for-service beneficiaries who were nursing home residents between 2011 and 2017. Percentages of pressure ulcers that were appropriately reported by stage, long-stay versus short-stay status, and race was calculated. Reporting rates were low for both short-stay (70.2%) and long-stay (59.7%) for stage 2-4 pressure ulcer hospitalizations. Black residents experienced more severe pressure ulcers than White residents. Correlations between claims-based measures and NHC ratings were found to be poor.
AHRQ-funded; HS026957.
Citation: Chen Z, Gleason LJ, Sanghavi P .
Accuracy of pressure ulcer events in US nursing home ratings.
Med Care 2022 Oct;60(10):775-83. doi: 10.1097/mlr.0000000000001763.
AHRQ-funded; HS026957..
AHRQ-funded; HS026957..
Keywords: Elderly, Nursing Homes, Long-Term Care, Pressure Ulcers, Quality Measures, Quality of Care, Patient Safety
Baernholdt M, Yan G, Hinton ID
Effect of preventive care interventions on pressure ulcer rates in a national sample of rural and urban nursing units: Longitudinal associations over 4 years.
This study looked at the effects of nursing care interventions aimed at preventing pressure ulcers in rural and urban hospitals over a 4-year period. This longitudinal study used unit-level data from the National Database of Nursing Quality Indicators 2010-2013. The authors analyzed 5761 units (332 rural and 5429 urban) in 772 hospitals (89 rural and 683 urban) that reported ulcer rates in two or more quarters. Outcomes from use of a three-care intervention combination was measured with decreases in pressure ulcers shown from any of those interventions (patients receiving skin assessment on admission, receiving risk assessment on admission, and receiving any risk assessment before the pressure ulcer). An increase in RN skill mix and two nurse outcomes (increase in job satisfaction and intent-to-stay) also led to decreases in ulcer rates.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Yan G, Hinton ID .
Effect of preventive care interventions on pressure ulcer rates in a national sample of rural and urban nursing units: Longitudinal associations over 4 years.
Int J Nurs Stud 2020 May;105:103455. doi: 10.1016/j.ijnurstu.2019.103455..
Keywords: Pressure Ulcers, Prevention, Skin Conditions, Nursing, Practice Patterns, Provider: Nurse, Provider, Quality Indicators (QIs), Quality Measures, Quality of Care
Baernholdt M, Hinton ID, Guofen Y
A national comparison of rural/urban pressure ulcer and fall rates.
Despite recent decline in hospital acquired conditions (HACs), rates for pressure ulcers (PURs) and falls (FRs) remain at levels that require improvement. Contextual factors and care processes may impact HACs. Using the National Database of Nursing Quality Indicators (NDNQI®) this study examined differences in care processes and community, hospital, and nursing unit characteristics that influence PURs and FRs in 4238 rural and urban nursing units.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Hinton ID, Guofen Y .
A national comparison of rural/urban pressure ulcer and fall rates.
Online J Issues Nurs 2017 May;22(2):1-12. doi: 10.3912/OJIN.Vol22No02PPT60..
Keywords: Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures, Rural Health, Urban Health