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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 5 of 5 Research Studies Displayed
Fashaw SA, Thomas KS, McCreedy E
Thirty-year trends in nursing home composition and quality since the passage of the Omnibus Reconciliation Act.
In 1987, the Omnibus Reconciliation Act (OBRA) called for a dramatic overhaul of the nursing home (NH) quality assurance system. This study examined trends in facility, resident, and quality characteristics since passage of that legislation. The investigators indicated that the 30th anniversary of OBRA provided a unique opportunity to reflect, consider lessons learned, and think about the future of this and other sectors of long-term care
Citation: Fashaw SA, Thomas KS, McCreedy E . Thirty-year trends in nursing home composition and quality since the passage of the Omnibus Reconciliation Act. J Am Med Dir Assoc 2020 Feb;21(2):233-39. doi: 10.1016/j.jamda.2019.07.004..
Keywords: Nursing Homes, Quality of Care, Long-Term Care, Policy
Makam AN, Nguyen OK, Kirby B
Effect of site-neutral payment policy on long-term acute care hospital use.
The purpose of this study was to assess the projected effect of the Centers for Medicare and Medicaid Services new site-neutral payment policy, which aims to decrease unnecessary long-term acute care hospital (LTACH) admissions by reducing reimbursements for less-ill individuals by 2020. The investigators concluded that the site-neutral payment policy may limit LTACH access in existing LTAC-scarce markets, with potential adverse implications for recovery of hospitalized older adults.
Citation: Makam AN, Nguyen OK, Kirby B . Effect of site-neutral payment policy on long-term acute care hospital use. J Am Geriatr Soc 2018 Nov;66(11):2104-11. doi: 10.1111/jgs.15539..
Keywords: Policy, Hospitalization, Payment, Long-Term Care, Healthcare Costs, Medicare, Elderly, Hospitals
Urick BY, Kaskie BP, Carnahan RM
Improving antipsychotic prescribing practices in nursing facilities: the role of surveyor methods and surveying agencies in upholding the Nursing Home Reform Act.
The objectives of this study were to explore surveyor observations of skilled nursing facilities/nursing facilities care practices subsequent to participation the Partnership guidance program and to use a social ecological framework to estimate how these observations were influenced by individual, organizational, and contextual factors. It found substantial variation in surveyor observations of changes to clinical care in response to the Partnership guidance initiative.
Citation: Urick BY, Kaskie BP, Carnahan RM . Improving antipsychotic prescribing practices in nursing facilities: the role of surveyor methods and surveying agencies in upholding the Nursing Home Reform Act. Res Social Adm Pharm 2016 Jan-Feb;12(1):91-103. doi: 10.1016/j.sapharm.2015.04.006.
Keywords: Elderly, Nursing Homes, Long-Term Care, Policy, Medication, Organizational Change
Abrahamson K, Miech E, Davila HW
Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study.
The researchers explored ways in which data were collected, thought about and used by nursing home employees as a result of participation in a pay-for-performance (P4P) program. Their findings indicated that participants in the Minnesota Performance-based Incentive Payment Program’s quality improvement (QI) projects perceived a change in the rate and manner in which they gathered, used, and considered data in their QI decisions.
Citation: Abrahamson K, Miech E, Davila HW . Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study. BMJ Qual Saf. 2015 May;24(5):311-7. doi: 10.1136/bmjqs-2014-003362..
Keywords: Nursing Homes, Long-Term Care, Payment, Provider Performance, Decision Making, Policy, Quality Improvement, Quality of Care
Spector WD, Limcangco R, Williams C
AHRQ Author: Spector WD
Potentially avoidable hospitalizations for elderly long-stay residents in nursing homes.
The authors sought to determine the relationship between clinical risk factors, facility characteristics and State policy variables, and both avoidable and unavoidable hospitalizations. Using data from the Nursing Home Stay file, 2006-2008, they found that three fifths of hospitalizations were potentially avoidable and most were for infections, injuries, and congestive heart failure. Clinical risk factors included renal disease, diabetes, and a high number of medications. Staffing, quality, and reimbursement affected avoidable, but not unavoidable, hospitalizations.
Citation: Spector WD, Limcangco R, Williams C . Potentially avoidable hospitalizations for elderly long-stay residents in nursing homes. Med Care 2013 Aug;51(8):673-81. doi: 10.1097/MLR.0b013e3182984bff.
Keywords: Elderly, Hospitalization, Long-Term Care, Nursing Homes, Policy