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This report was produced by the Federal Interagency Forum on Aging Related Statistics.

This report was produced by the Federal Interagency Forum on Aging Related Statistics. For more information visit the Forum’s web site at www.agingstats.gov or call 301-458-4460. MODELING THE OUTCOMES OF NURSING HOME CARE Rohrer and Hogan, Soc Sci Med 24(3) 1987

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This report was produced by the Federal Interagency Forum on Aging Related Statistics.

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  1. This report was produced by the Federal Interagency Forum on Aging Related Statistics. For more information visit the Forum’s web site at www.agingstats.gov or call 301-458-4460

  2. MODELING THE OUTCOMES OF NURSING HOME CARE Rohrer and Hogan, Soc Sci Med 24(3) 1987 290 VA NH pts - 243 remaining Are the number of minutes of nursing care associated with outcomes when case mix is controlled?

  3. Results of Regression Analysis of Outcome RUG (R -square=.71, N=234) LPN/Aides -.005 Psychosocial -.002 Basic .005 MD notes -.159 RN .013 Initial RUG .475 Rehab n.s.

  4. CONCLUSIONS • The amount of nursing care is associated with outcome functional status. • Non-RN time is associated with better outcomes • RN time is associated with worse outcomes (ameliorative) • Rehab service was not associated with outcomes (constrained range?)

  5. ORGANIZATIONAL PREDICTORS OF OUTCOMES OF LONG-STAY NURSING HOME RESIDENTS • Rohrer et al, Soc Sci Med, 1993 • 10 nursing homes, 32 units, 872 cases • Measures • job assignment vs flexible duties • hierarchy (number of levels of supervision) • closeness of supervision (RNs/nonRNS) • pace (discharges/beds) • workload (percent heavy care residents) • initial and outcome functioning

  6. REGRESSION RESULTS (R-Square=.74) • Job assignment 0.068 • Hierarchy 0.153 • Closeness of supervision n.s. • Pct heavy care 0.207 • Pace 1.044 • Hierarchy x pace -1.074 • Initial functioning 0.743

  7. CONCLUSIONS Residents get worse: under strict job assignment tall hierarchies / large organizations where workload is heavy when pace is fast Residents get better: in large organizations when pace is fast Contingency theory applies - optimal structure depends on circumstances

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