Facility and State Variation in Hip Fracture in U.S. Nursing Home Residents

Facility and State Variation in Hip Fracture in U.S. Nursing Home Residents Prior studies suggest that nursing home (NH) facility characteristics and care practices influence the risk of adverse events in NH residents. Recent studies have shown that differences in resident characteristics cannot fully explain differences in antipsychotic prescribing, hospitalization rates, and other healthcare events between NH facilities. It is likely that facility characteristics such as profit status, nurse staffing, NH size, and chain affiliation are contributors to NH residents’ risk of adverse outcomes.The medical director and other NH staff and also state regulations influence facility practices. Local practices, such as an intervention to reduce recurrent falls, may influence adverse events in a specific facility or chain. State regulations, such as the minimum staffing level required in NHs, could influence the ability of facilities in a state to provide the level of care necessary to prevent falls and fractures. Policies and regulations vary considerably across states.Hip fractures are significant adverse events in U.S. NHs given their high associated morbidity, mortality, and expense. Resident‐specific risk factors for hip fracture have been well established and overlap with risk factors for falls, because hip fractures often occur in the setting of a fall. Prior work has documented meaningful variation in the rates of hip http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of American Geriatrics Society Wiley

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 American Geriatrics Society and Wiley Periodicals, Inc.
ISSN
0002-8614
eISSN
1532-5415
D.O.I.
10.1111/jgs.15264
Publisher site
See Article on Publisher Site

Abstract

Prior studies suggest that nursing home (NH) facility characteristics and care practices influence the risk of adverse events in NH residents. Recent studies have shown that differences in resident characteristics cannot fully explain differences in antipsychotic prescribing, hospitalization rates, and other healthcare events between NH facilities. It is likely that facility characteristics such as profit status, nurse staffing, NH size, and chain affiliation are contributors to NH residents’ risk of adverse outcomes.The medical director and other NH staff and also state regulations influence facility practices. Local practices, such as an intervention to reduce recurrent falls, may influence adverse events in a specific facility or chain. State regulations, such as the minimum staffing level required in NHs, could influence the ability of facilities in a state to provide the level of care necessary to prevent falls and fractures. Policies and regulations vary considerably across states.Hip fractures are significant adverse events in U.S. NHs given their high associated morbidity, mortality, and expense. Resident‐specific risk factors for hip fracture have been well established and overlap with risk factors for falls, because hip fractures often occur in the setting of a fall. Prior work has documented meaningful variation in the rates of hip

Journal

Journal of American Geriatrics SocietyWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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