OBJECTIVES: To compare the mortality rate in regulated and unregulated facilities, controlling for confounding variables, and investigate the effect of care quality on residents' length of survival. DATA SOURCES/STUDY SETTING: At baseline, subjects were assessed in their living environment with respect to their functional autonomy, cognitive abilities, and quality of care. Vital status, disease-related information, and hospitalization data were retrieved three years later from the subjects' medical files. STUDY DESIGN: A three-year follow-up study of 299 residents from 88 long-term care facilities located in the province of Quebec, Canada. The effect of regulatory status and quality of care on length of survival was investigated by means of multivariable Cox proportional hazards regression models, from both traditional and competing risks perspectives. PRINCIPAL FINDINGS: Controlling for age, comorbidity, and baseline functional abilities, a resident's length of survival is not significantly influenced by the regulatory status of the facility in which he or she lived at baseline. However, residents with poor quality ratings at baseline had shorter survival times than those provided with good care. Median survival was 28 months among residents classified as receiving inadequate care compared to 41 months for those adequately cared for (p = 0.0217). CONCLUSIONS: The study suggests that quality of care has a much stronger influence on resident outcomes than regulation per se. This finding underscores the relevance of testing innovative interventions aimed at improving the quality of care provided in long-term care facilities, regardless of their regulatory status.
OBJECTIVES: To compare the mortality rate in regulated and unregulated facilities, controlling for confounding variables, and investigate the effect of care quality on residents' length of survival. DATA SOURCES/STUDY SETTING: At baseline, subjects were assessed in their living environment with respect to their functional autonomy, cognitive abilities, and quality of care. Vital status, disease-related information, and hospitalization data were retrieved three years later from the subjects' medical files. STUDY DESIGN: A three-year follow-up study of 299 residents from 88 long-term care facilities located in the province of Quebec, Canada. The effect of regulatory status and quality of care on length of survival was investigated by means of multivariable Cox proportional hazards regression models, from both traditional and competing risks perspectives. PRINCIPAL FINDINGS: Controlling for age, comorbidity, and baseline functional abilities, a resident's length of survival is not significantly influenced by the regulatory status of the facility in which he or she lived at baseline. However, residents with poor quality ratings at baseline had shorter survival times than those provided with good care. Median survival was 28 months among residents classified as receiving inadequate care compared to 41 months for those adequately cared for (p = 0.0217). CONCLUSIONS: The study suggests that quality of care has a much stronger influence on resident outcomes than regulation per se. This finding underscores the relevance of testing innovative interventions aimed at improving the quality of care provided in long-term care facilities, regardless of their regulatory status.
Authors: Cathleen S Colón-Emeric; Donde Plowman; Donald Bailey; Kirsten Corazzini; Queen Utley-Smith; Natalie Ammarell; Mark Toles; Ruth Anderson Journal: Qual Health Res Date: 2010-05-17
Authors: Alexandra Papaioannou; Nancy Santesso; Suzanne N Morin; Sidney Feldman; Jonathan D Adachi; Richard Crilly; Lora M Giangregorio; Susan Jaglal; Robert G Josse; Sharon Kaasalainen; Paul Katz; Andrea Moser; Laura Pickard; Hope Weiler; Susan Whiting; Carly J Skidmore; Angela M Cheung Journal: CMAJ Date: 2015-09-14 Impact factor: 8.262
Authors: Ahmed M Negm; George Ioannidis; Micaela Jantzi; Jenn Bucek; Lora Giangregorio; Laura Pickard; John P Hirdes; Jonathan D Adachi; Julie Richardson; Lehana Thabane; Alexandra Papaioannou Journal: BMC Geriatr Date: 2018-12-27 Impact factor: 3.921
Authors: George Ioannidis; Micaela Jantzi; Jenn Bucek; Jonathan D Adachi; Lora Giangregorio; John Hirdes; Laura Pickard; Alexandra Papaioannou Journal: BMJ Open Date: 2017-09-01 Impact factor: 2.692