Abstract
Objectives
To examine the relationship between post-acute care (PAC) quality improvement and
long-term care (LTC) quality changes.
Design
Observational study using national nursing home data from Nursing Home Compare linked
to Brown University's LTCFocus data.
Setting and Participants
Free-standing nursing homes serving PAC and LTC residents in the United States.
Methods
This study used pooled cross-sectional analysis with nursing home–level data from
2005 to 2010 (12,150 unique nursing homes). We used fixed effects models to examine
the association between a 1-year change in PAC quality and a 1-year change in LTC
quality, with a specific focus on related care domains.
Results
Strong and positive associations were found between related PAC and LTC care domains,
particularly between the PAC and LTC influenza vaccination care domains (β = 0.30,
P < .001) and the PAC and LTC pneumococcal vaccination care domains (β = 0.55, P < .001). Meanwhile, model results showed PAC quality changes essentially had no associations
with unrelated LTC care domains.
Conclusions and Implications
This is the first study that examines the association of changes in quality between
2 overlapping but different care domains (ie, PAC and LTC) using multiple quality
measures. Our findings indicate that nursing homes can manage concurrent quality improvement
in PAC and LTC, particularly on care domains that are related. More research is needed
to examine the mechanism that enables such concurrent quality improvement.
Keywords
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Article info
Publication history
Published online: November 22, 2020
Footnotes
This work was supported by The Patrick and Catherine Weldon Donaghue Medical Research Foundation (grant no. DF-AL2015) to Jennifer Gaudet Hefele.
The authors declare no conflicts of interest.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
