Nursing Home Staffing Levels and Resident Health Outcomes: Is the Role of the Physical Therapist Undervalued?

IF 4.2 2区 医学 Q2 GERIATRICS & GERONTOLOGY Journal of the American Medical Directors Association Pub Date : 2024-12-17 DOI:10.1016/j.jamda.2024.105422
Abubakar Sadiq Bouda Abdulai
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Abstract

Objectives: To assess the relationship between nursing home staffing levels and excess outpatient emergency department (ED) visits by residents.

Study design: A retrospective analysis of nursing home facility-level data.

Setting and participants: A total of 14,860 Medicare- and Medicaid-certified long-term care facilities in the United States.

Methods: Using publicly available data from the Centers for Medicare and Medicaid Services database for the period October 1, 2022, to September 30, 2023, we used linear regression analysis to assess the association between facility-level rates of excess outpatient emergency department (ED) visits by residents and staffing hours per resident per day for physical therapists, registered nurses, nurse aides, and licensed practical nurses, controlling for other facility characteristics.

Results: For long-stay residents, an increase in physical therapist (PT) hours per resident per day was negatively associated with excess ED utilization (-0.58 per 1000; 95% CI, -0.91 to -0.25; P < .001). Similarly, registered nurse (RN) hours per resident per day were significantly associated with a decrease in excess ED utilization (-0.27 per 1000; 95% CI, -0.35 to -0.19; P < .001). For short-stay residents, although RN hours showed a significant negative association (-0.69%; 95% CI, -1.03 to -0.35; P < .001), PT hours did not reach statistical significance (-0.88%; 95% CI, -2.36 to 0.60). Nurse aide and licensed practical nurse hours did not significantly correlate with excess visits for long- and short-stay residents.

Conclusions and implications: The findings underscore the significance of an optimal combination of nursing home staff to reduce excess outpatient ED visits, particularly for long-stay residents. They point to the need for policy measures that promote balanced staffing levels across different roles to effectively minimize excess outpatient ED visits by residents.

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来源期刊
CiteScore
11.10
自引率
6.60%
发文量
472
审稿时长
44 days
期刊介绍: JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates. The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality
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