Organizational relationships between nursing homes and hospitals and quality of care during hospital-nursing home patient transfers

被引:32
作者
Boockvar, Kenneth S.
Burack, Orah R.
机构
[1] James J Peters VA Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY 10468 USA
[2] Jewish Home & Hosp Lifecare Syst, New York, NY USA
[3] Mt Sinai Sch Med, Brookdale Dept Geriatr & Adult Dev, New York, NY USA
关键词
nursing homes; hospitals; organizational affiliation; patient transfer; safety management;
D O I
10.1111/j.1532-5415.2007.01235.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
OBJECTIVES: To identify organizational factors and hospital and nursing home organizational relationships associated with more-effective processes of care during hospital-nursing home patient transfer. DESIGN: Mailed survey. SETTING: Medicare- or Medicaid-certified nursing homes in New York State. PARTICIPANTS: Nursing home administrators, with input from other nursing home staff. MEASUREMENTS: Key predictor variables were travel time between the hospital and the nursing home, affiliation with the same health system, same corporate owner, trainees from the same institution, pharmacy or laboratory agreements, continuous physician care, number of beds in the hospital, teaching status, and frequency of geriatrics specialty care in the hospital. Key dependent variables were hospital-to-nursing home communication, continuous adherence to healthcare goals, and patient and family satisfaction with hospital care. RESULTS: Of 647 questionnaires sent, 229 were returned (35.4%). There was no relationship between hospital-nursing home interorganizational relationships and communication, healthcare goal adherence, and satisfaction measures. Geriatrics specialty care in the hospital (r=0.157; P=.04) and fewer hospital beds (r=-0.194; P=.01) were each associated with nursing homes more often receiving all information needed to care for patients transferred from the hospital. Teaching status (r=0.230; P=.001) and geriatrics specialty care (r=0.185; P=.01) were associated with hospital care more often consistent with healthcare goals established in the nursing home. CONCLUSION: No management-level organizational relationship between nursing home and hospital was associated with better hospital-to-nursing home transfer process of care. Geriatrics specialty care and characteristics of the hospital were associated with better hospital-to-nursing home transfer processes.
引用
收藏
页码:1078 / 1084
页数:7
相关论文
共 30 条
[1]  
Anderson M A, 1998, Image J Nurs Sch, V30, P255
[2]   Adverse events due to discontinuations in drug use and dose changes in patients transferred between acute and long-term care facilities [J].
Boockvar, K ;
Fishman, E ;
Kyriacou, CK ;
Monias, A ;
Gavi, S ;
Cortes, T .
ARCHIVES OF INTERNAL MEDICINE, 2004, 164 (05) :545-550
[3]  
Boockvar Kenneth S, 2006, Am J Geriatr Pharmacother, V4, P236, DOI 10.1016/j.amjopharm.2006.09.003
[4]  
Bowlyow J E, 1990, Med Care Rev, V47, P75, DOI 10.1177/107755879004700105
[5]   Hospitalization of nursing home residents: A review of the literature, 1980-1995 [J].
Castle, NG ;
Mor, V .
MEDICAL CARE RESEARCH AND REVIEW, 1996, 53 (02) :123-148
[6]   Inpatient care for nursing home patients: An opportunity to improve transitional care [J].
Cheng, Huai Y. ;
Tonorezos, Emily ;
Zorowitz, Robert ;
Novotny, John ;
Dubin, Shelly ;
Maurer, Mathew S. .
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 2006, 7 (06) :383-387
[7]  
COBURN AF, 1996, J APPL GERONTOL, V15, P101
[8]   Improving the quality of transitional care for persons with complex care needs [J].
Coleman, EA ;
Boult, C .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2003, 51 (04) :556-557
[9]   Posthospital care transitions: Patterns, complications, and risk identification [J].
Coleman, EA ;
Min, SJ ;
Chomiak, A ;
Kramer, AM .
HEALTH SERVICES RESEARCH, 2004, 39 (05) :1449-1465
[10]   Preparing patients and caregivers to participate in care delivered across settings: The care transitions intervention [J].
Coleman, EA ;
Smith, JD ;
Frank, JC ;
Min, SJ ;
Parry, C ;
Kramer, AM .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2004, 52 (11) :1817-1825