References
- General Accounting Office. Nursing home quality. US General Accounting Office, Washington, DC, USA GA0-03-561 (2003).
- Berg K, Fries BE, Jones R et al Identification and evaluation of existing quality indicators that are appropriate for use in long-term care settings. Centers for Medicare and Medicaid Services, MD, USA (2001).
- Weiner JM and Stevenson DG. State policy on long-term care for the elderly. Health Affairs 17(3), 81–100 (1998).
- Gage B. Impact of the BBA on postacute utilization. Healthcare Finan. Rev 20(4), 103–126 (1999).
- Pratt JR. Competition, co-operation and integration. In: Long-Term Care: Managing-Across the Continuum. Pratt JR (Ed.). Gaithersburg, MD, USA, 261–294 (1999).
- Zinn JS, Mor V, Castle N, Intrator O, Brannon D. Organizational and environmental factors associated with nursing home participation in managed care. Health Serv Res. 33(6), 1753–1767 (1999).
- Smith V, Ramesh R, Gifford K, Ellis E, Wachino V. States Respond to Fiscal Pressure: State Medicaid Spending Growth and Cost Containment in Fiscal Yeats 2003 and 2004. Kaiser Commission on Medicaid and the Uninsured, Washington DC, USA (2003).
- Davis MA. On nursing home quality: a review and analysis. Med. Care Rev 48 (2), 166–203 (1991).
- ••Reviews the scientific literature of some of the major correlates of nursing home quality Specifically, examines the relations between quality and facility size, expenditures, human resources, ownership mode and source of payment. Quality is conceptualized using Donabedian's structure—process-outcome framework.
- Ramsay JD, Sainfort F, Zimmerman D. An empirical test of the structure, process and outcome quality paradigm using resident-based, nursing facility assessment data. Amj Med. Qual 10(2), 63–75 (1995).
- Becker SW Shortell SM, Neuhauser D. Management practice and hospital lengths of stay. Inquiry318-330 (1980).
- Shortell SM, Becker SW Neuhauser D. The effects of management practices on hospital efficiency and quality of care. In: Organizational Research in Hospitals. Shortell SM, Brown M (Eds). Inquiry Book, Blue Cross Association, IL, USA, 90–112 (1976).
- American Medical Association. Quality of care. JA/V/A 556,1032–1034 (1986).
- Donabedian A. The quality of care: how can it be assessed? JAIVIA 260(12), 1743–1748 (1988).
- •• Presents the structure—process-outcome framework of quality assessment. This framework has been widely used in previous studies examining nursing home quality of care.
- Gustafson DH, Hundt AS. Findings of innovation research applied to quality management principles for healthcare. Healthcare Manage. Rev. 20(2), 16–33 (1995).
- Kane RA, Kane RL. Long-term care: variations on a quality assurance theme. Inquiry25(1), 132–146 (1988).
- Sainfort F, Ramsay JD, Monato H. Conceptual and methodological sources of variation in the measurement of nursing facility quality: an evaluation of 24 models and an empirical study. Med. Care Res. Rev 52(1), 60–87 (1995).
- Bishop CE. Nursing home cost studies and reimbursement issues. Healthcare Financ. Rev 2(3), 47–64 (1980).
- Newhouse JP. Toward a theory of nonprofit institutions: an economic model of a hospital. Am Econ. Rev 60(1), 64–74 (1970).
- Fleming ST The relationship between the cost and quality of hospital care: a review of the literature. Med. Care Rev 47(4), 487–502 (1990).
- Porter ME. Competitive Advantage. The Free Press, NY, USA (1985).
- Phillips LW, Chang DR, Buzzell RD. Product quality, cost position and business performance: a test of some key hypotheses. J. Marketing 47, 26–43 (1983).
- Porter ME. Competitive Strategy The Free Press, NY, USA (1980).
- Daigh RD. Financial implications of a quality improvement process. Top. Healthcare Financ. 17(3), 42–52 (1991).
- Binns GS. The relationship among quality, cost and market share in hospitals. Top.Healthcare Financ. 18(2), 21–32 (1991).
- Agency for Healthcare Policy and Research (AHCPR). Treatment of Pressure Ulcers. Clinical Practice Guideline, No. 15 Rockville (MD): US Department of Health and Human Services, Public Health Service, AHCPR (1994).
- Berlowitz DR, Halpern J. Evaluating and improving pressure ulcer care: the VA experience with administrative data. Joint Commission Qual Improve. 23(8), 424–33 (1997).
- Xakellis GC, Frantz RA, Lewis A, Harvey P. Cost-effectiveness of an intensive pressure ulcer prevention protocol in long-term care. Advance. Wound Care 11, 22–29 (1998).
- Phillips CD, Hawes C, Fries BE. Reducing the use of physical restraints in nursing homes: will it increase costs? Am J Pub. Health 83(3), 342–348 (1993).
- Castle NG, Mor V. Physical restraints in nursing homes: a review of the literature since the Nursing Home Reform Act of 1987. Med Care Res. Rev 55(2), 139–176 (1998).
- Frantz RA, Bergquist S, Specht J. The cost of treating pressure ulcers following implementation of a research-based skin care protocol in a long-term care facility. Advance. Wound Care 8 (1), 36–45 (1995).
- Mukamel DB, Spector WD. Nursing home costs and risk-adjusted outcome measures of quality. Med. Care38(1), 78–89 (2000).
- ••Estimates cost functions for nursing homes in New York based on three risk-adjusted outcome measures: deterioration in functional status, worsening of pressure ulcers and mortality They found that the cost—quality relationship for nursing homes was nonmonotonic with an inverted 1.5' shape. There are care regimens where nursing homes are able to achieve both lower costs and better quality of care.
- Nyman JA. Improving the quality of nursing home outcomes: are adequacy- or incentive-oriented policies more effective? Med. Care 26 (4), 1158–1171 (1988).
- Weech-Maldonado R, Neff G, Mor V. Does quality of care lead to better financial performance? The case of the nursing home industry. Healthcare Manage. Rev 28(3), 201–216 (2003).
- ••Examines the direct and indirect effects ofstructure, process and outcome quality on costs using structural equation modeling. Greater registered nurse (RN) staffing (structure measure) leads to higher costs but higher RN staffing has an indirect negative effect on costs via its positive effect on outcomes of care. While process quality (lower use of restraints and lower catherization rates) does not exhibit a significant relationship with costs, better process of care has an indirect negative effect on costs via its positive effect on outcomes of care. Finally, facilities with better outcomes quality (lower pressure ulcers and mood decline) have lower costs.
- Weech-Maldonado R, Neff G, Mor V. The relationship between quality of care and financial performance in nursing home.j Healthcare Finance 29 (3), 48–60 (2003).
- Weech-Maldonado R, Shea D, Mor V. The Relationship between Costs and Quality of Care in Nursing- Homes. Pennsylvania State University, Gerontology Center Working Paper No. 470 (2003).
- ••Uses a multistate sample and incorporates instrumental variables for the quality measures to account for potential cost—quality endogeneity. The authors found that the relationship between costs and quality was nonmonotonic. In addition, they found the cost—quality relationship to vary depending on the outcome of care. While pressure ulcers exhibited an inverted 'U' shape curve, mood decline showed a relatively flat curve at the lower range of quality but increasing costs were associated with improved quality after a threshold.
- Carpenter GI, Ikegami N, Ljunggren G et al RUG-III and resource allocation: comparing the relationship of direct care time with patient characteristics in five countries. Age Ageing2,61–65 (1997).
- Fries BE, Schneider DP, Foley WJ et al Refining a case mix measure for nursing homes: Resource Utilization Groups . Med Care 32 (7), 668–685 (1994).
- Swan JH, Harrington C, Clemena W, Pickard RB, Studer L, DeWit SK. Medicaid nursing facility reimbursement methods: 1979–1997. Med Care Res. Rev. 57(3), 361–378 (2000).
- Davis MA, Freeman JW. Excess demand and cost relationships among Kentucky nursing homes. Healthcare Financ. Rev. 15(4), 137–152 (1994).
- Donabedian A, Wheeler JRC, Wyszewianski L. Quality, cost and the health: an integrative model. Med Care 20(10), 975–992 (1982).
- Fleming ST The relationship between quality and cost: pure and simple? Inquiry 28,29–38 (1991).
- ••Focuses on the relationship between quality and the cost of hospital care. The author found that the relationship between cost and quality is nonlinear and nonmonotonic. However, the relationship between quality and costs depends on the quality measure used.
- Gertler PJ, Waldman DM. Quality- adjusted cost functions and policy evaluation in the nursing home industry. J. Pout. Econ. 100(6), 1232–1256 (1992).
- Chen L, Shea DG. Does prospective payment really contain nursing home costs? Health Serv Res. 37(2), 251–271 (2002).
- ••Examines whether nursing homes have lower costs in states using prospective payment systems (PPS) compared with facilities under retrospective cost-based payment systems, after controlling for quality differences among facilities. This article uses a national sample of nursing homes and it addresses potential endogeneity of quality by creating instrumental variables for the quality variables. The authors found that nursing homes in states using PPS do not have lower costs than their counterpart facilities under restrospective cost-based payment systems.
- Zinn JS. Market competition and the quality of nursing home care. J Health Politics, Policy Law19(3), 555–582 (1994).
- Nyman JA. The effect of competition on nursing home expenditures under prospective reimbursement. Health Serv. Res. 23(4), 555–574 (1988).
- ••One of the first studies to examine theimpact of market competition on nursing home costs. Using a sample of Wisconsin facilities, they found that nursing homes located in markets with tight bed supplies have greater expenditures per patient day than those located in areas where the bed supply is relatively abundant.
- Gapenski L. Healthcare Finance: an Introduction to Accounting- and Financial Management. Second Edition. Health Administration Press, IL, USA (2002).
- Birnbaum H, Lee AJ, Jensen G. Why do nursing home costs vary? The determinants of nursing home costs. Med Care 19(11), 1095–1107 (1981).
- Harrington C, Swan JH et al The effect of certificate of need and moratoria policy on change in nursing home beds in the United States. Med. Care 35(6), 574–588 (1997).
- Felton BB. How organization of nursing care and resident health status affect nursing home costs. Nursing Outlook 41 (1), 10–14 (1993).
- Lee AJ, Birnbaum H. The determinants of nursing home operating costs in New York State. Health Serv. Res. 18(2), 285–308 (1983).
- Meiners, MR. An econometric analysis of the major determinants of nursing home costs in the United States. Soc. ScL Med 16(8), 887–898 (1982).
- Smith HL, Fottler MD. Costs and cost containment in nursing homes. Health Serv. Res. 16(1), 17–41 (1981).
- Ullmann SG. The impact of quality on cost in the provision of long-term care. Inquiry 22, 293–302 (1985).
- Schlenker RE, Shaughnessy PW. Case mix, quality and cost relationships in Colorado nursing homes. Healthcare Financ. Rev. 6(2), 61–71 (1984).
- Institute of Medicine (TOM). Nursing Staff Adequate.Munderlich GS, Sloan FA, Davis CK (Eds). National Academy Press, Washington DC, USA (1996).
- Braun BI. The effect of nursing home quality on patient outcome. J. Am. Geriatrics Soc. 39, 329–338 (1991).
- Graber DR, Sloane PD. Nursing home survey deficiencies for physical restraint use. Med. Care 33 (10), 1051–1063 (1995).
- Munroe DJ. The influence of registered nurse staffing on the quality of nursing home care. Res. Nursing- Health 13, 263–270 (1990).
- Anderson RA, Hsich P, Su H. Resource allocation and resident outcomes in nursing homes: comparisons between the best and worst. Res. Nurs. Health 21,297–313 (1998).
- Linn MW, Gurel L, Linn BS. Patient outcome as a measure of quality of nursing home care. Am j Pub. Health 67 (4), 337–342 (1977).
- Rudder C, Phillips C. 91 Ideas for Reducing Costs, Enhancing Revenue and Maintaining Quality in Nursing- Homes. Project report to The Fan Fox and Leslie R. Samuels Foundation, USA (1998).
- Weech-Maldonado R, Zinn J, Brannon D. Managerial implications of corporate board involvement and perceived market competition for quality improvement in nursing homes. j Healthcare Manage. 44(5), 382–395 (1999).
- Weech-Maldonado R, Zinn J, Hamilton R. The performance impact of context in TQM implementation: the nursing facility industry. Health Serv. Manage. Res. 14, 147–158 (2001).
- Berlowitz DR, Young GJ et al Quality improvement implementation in the nursing home. Health Serv. Res. 38(1 Pt 1), 65–83 (2003).
- Palm DW, Nelson S. The Determinants of nursing home costs in Nebraska's proprietary nursing homes. Socioeconomic Ran. Sci. 18(3), 171–177 (1984).
- Christianson JB. Long-term standards: enforcement and compliance. j Health Politics, Policy Law 4(3), 141–134 (1979).
- Ullmann SG. Cost analysis and facility reimbursement in the long-term healthcare industry. Health Serv. Res. 19 (1), 83–102 (1984).
- Ullmann SG. Ownership, regulation, quality assessment and performance in the long-term healthcare industry. Gerontologist 27 (2), 233–239 (1987) .
- Donabedian A. Evaluating the quality of medical care. Ifrlilbank IVIemorial Fund Quarterly44 (3), (Suppl.) 166–206 (1966).
- Abt. Associates Inc. Appropriateness of mum Staffing Ratios in Nursing Homes. Report to Congress: Phase II Final. Centers for Medicare and Medicaid Services, Baltimore, MD, USA (2001).
Websites
- Centers for Medicare and Medicaid Services (CMS). Nursing home quality initiative. Centers for Medicare and Medicaid Services. http://cms.hhs.gov/providers/ nursinghomes/nhi/(Accessed October 2003).