Abstract:
OBJECTIVES:We examined differences in quality of care among nursing homes in locales of varying degrees of rurality. METHODS:We classified locales into 4 classes according to rurality. We analyzed a 10% sample of nursing home admissions in the United States in 2000 (n=198613) to estimate survival models for 9 quality indicators. RESULTS:For postacute admissions, we observed significant differences in rates of decline for residents in facilities in large towns compared with urban areas, but differences in quality were both negative and positive. Among admissions for long-term or chronic care, rates of decline in 2 of 9 quality areas were lower for residents in isolated areas. CONCLUSIONS:We observed significant differences in a number of quality indicators among different classes of nursing home locations, but differences varied dramatically according to type of admission. These differences did not exhibit the monotonicity that we would have expected had they derived solely from rurality. Also, quality indicators exhibited more similarities than differences across the 4 classes of locales. The results underscore the importance, in some instances, of emphasizing the effects of specific settings rather than some continuum of rurality and of moving beyond the assumption that nursing home residents constitute a homogeneous population.
journal_name
Am J Public Healthjournal_title
American journal of public healthauthors
Phillips CD,Holan S,Sherman M,Williams ML,Hawes Cdoi
10.2105/ajph.94.10.1717subject
Has Abstractpub_date
2004-10-01 00:00:00pages
1717-22issue
10eissn
0090-0036issn
1541-0048pii
94/10/1717journal_volume
94pub_type
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journal_title:American journal of public health
pub_type: 杂志文章
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journal_title:American journal of public health
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journal_title:American journal of public health
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