Laura M Wagner1, Paul Katz2, Jurgis Karuza3,4, Connie Kwong1, Lori Sharp5, Joanne Spetz1. 1. Healthforce Center, University of California, San Francisco. 2. Department of Geriatrics, Florida State University, Tallahassee. 3. Division of Geriatrics, University of Rochester School of Medicine and Dentistry, New York. 4. The Psychology Department, State University College at Buffalo, New York. 5. American Medical Directors Association, Columbia, Maryland.
Abstract
BACKGROUND AND OBJECTIVES: Medical providers are significant drivers of care in post-acute long-term care (PALTC) settings, yet little research has examined the medical provider workforce and its role in ensuring quality of care. RESEARCH DESIGN AND METHODS: This study examined the impact of nursing home medical staffing organization (NHMSO) dimensions on the quality of care in U.S. nursing homes. The principal data source was a survey specifically designed to study medical staff organization for post-acute care. Respondents were medical directors and attending physicians providing PALTC. We linked a number of medical provider and nursing home characteristics to the Centers for Medicaid and Medicare Services Nursing Home Compare quality measures hypothesized to be sensitive to input by medical providers. RESULTS: From the sample of nursing home medical providers surveyed (n = 1,511), 560 responses were received, yielding a 37% response rate; 425 medical provider responses contained sufficient data for analysis. The results of the impact of NHMSO dimensions were mixed, with many domains not having any significance or having negative relationships between provider characteristics and quality measures. Respondents who reported having a formal process for granting privileges and nursing homes with direct employment of physicians reported significantly fewer emergency visits. DISCUSSION AND IMPLICATIONS: Further research is needed regarding what quality measures are sensitive to both medical provider characteristics and NHMSO characteristics.
BACKGROUND AND OBJECTIVES: Medical providers are significant drivers of care in post-acute long-term care (PALTC) settings, yet little research has examined the medical provider workforce and its role in ensuring quality of care. RESEARCH DESIGN AND METHODS: This study examined the impact of nursing home medical staffing organization (NHMSO) dimensions on the quality of care in U.S. nursing homes. The principal data source was a survey specifically designed to study medical staff organization for post-acute care. Respondents were medical directors and attending physicians providing PALTC. We linked a number of medical provider and nursing home characteristics to the Centers for Medicaid and Medicare Services Nursing Home Compare quality measures hypothesized to be sensitive to input by medical providers. RESULTS: From the sample of nursing home medical providers surveyed (n = 1,511), 560 responses were received, yielding a 37% response rate; 425 medical provider responses contained sufficient data for analysis. The results of the impact of NHMSO dimensions were mixed, with many domains not having any significance or having negative relationships between provider characteristics and quality measures. Respondents who reported having a formal process for granting privileges and nursing homes with direct employment of physicians reported significantly fewer emergency visits. DISCUSSION AND IMPLICATIONS: Further research is needed regarding what quality measures are sensitive to both medical provider characteristics and NHMSO characteristics.
Authors: Hye-Young Jung; Hyunkyung Yun; Eloise O'Donnell; Lawrence P Casalino; Mark Aaron Unruh; Paul R Katz Journal: J Am Med Dir Assoc Date: 2022-04-13 Impact factor: 7.802