Hostname: page-component-848d4c4894-pjpqr Total loading time: 0 Render date: 2024-06-26T06:05:18.064Z Has data issue: false hasContentIssue false

Which Residential Care Facilities Are Delivering Inadequate Care? A Simple Case-Finding Questionnaire

Published online by Cambridge University Press:  29 November 2010

Marie-France Dubois
Affiliation:
Sherbrooke University Geriatric Institute
Gina Bravo
Affiliation:
Sherbrooke University Geriatric Institute
Michèle Charpentier
Affiliation:
Sherbrooke University Geriatric Institute

Abstract

The aim of this study was to develop a case-finding tool enabling the identification of residential care facilities that provide inadequate care to impaired older persons and assess its validity. This was done using data from a recent study that involved 88 homes for the aged located in the Eastern Townships of Quebec. For that study, facility managers were interviewed for information about themselves and their residence, while quality of care was assessed with the QUALCAEE Scale for each of 301 residents of the selected homes. Multivariate regression analyses helped develop a short questionnaire that can be completed during a telephone interview with the facility manager. With 85 per cent sensitivity and 65 per cent specificity in identifying homes delivering inadequate care, this case-finding questionnaire is simple, inexpensive and shows good evidence of validity.

Résumé

L'objectif de cette étude était de développer un outil de repérage des ressources d'hébergement qui dispensent des soins inadéquate à leur clientèle âgée en perte d'autonomie et d'en évaluer la validité. Elle a été réalisée à partir des données d'une étude récente menée auprès de 88 résidences pour personnes âgées en Estrie (province de Québec). Les caractéristiques générales des milieux étaient recueülies via une entrevue avec les responsables et la qualité des soins offerts aux résidants (n = 301) était évaluée à l'aide de l'échelle QUALCAEE. Des analyses de régression multivariées ont permis l'élaboration d'un court questionnaire pouvant être complété lors d'un entretien téléphonique avec le responsable. Ce questionnaire constitue un outil de repérage simple et peu dispendieux pour identifier les milieux dispensant des soins inadéquate. De plus, sa sensibilité de 85 pour cent et sa spécificité de 65 pour cent suggèrent une bonne validité.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aaronson, W.E., Zinn, J.S., & Rosko, W.D. (1994). Do for-profit and not-for-profit nursing homes behave differently? The Gerontologist, 34, 775786.CrossRefGoogle ScholarPubMed
Arling, G., Karon, S.L., Sainfort, F., Zimmerman, D.R., & Ross, R. (1997). Risk adjustment of nursing home quality indicators. The Gerontologist, 37, 757766.CrossRefGoogle ScholarPubMed
Berlowitz, D.R., Brandeis, G.H., & Moskowitz, M.A. (1997). Using administrative databases to evaluate long-term care. Journal of the American Geriatrics Society, 45, 618623.CrossRefGoogle ScholarPubMed
Bravo, G., Charpentier, M., Dubois, M.-F., De Wals, P., & Émond, A. (1998). Profile of residents in unlicensed homes for the aged in the Eastern Townships of Quebec. Canadian Medical Association Journal, 159, 1437–148.Google ScholarPubMed
Bravo, G., De Wals, P., Dubois, M.-F., & Charpentier, M. (1999). Correlates of care quality in long-term care facilities: a multilevel analysis. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 54B, P180–P188.CrossRefGoogle Scholar
Bravo, G., Dubois, M.-F., Charpentier, M., De Wals, P., & Émond, A. (1999). Quality of care in unlicensed homes for the aged in the Eastern Townships of Quebec. Canadian Medical Association Journal, 160, 14411448.Google ScholarPubMed
Bravo, G., Girouard, D., Gosselin, S., Archambault, C, & Dubois, M.-F. (1995). Further validation of the QUALCARE Scale. Journal of Elder Abuse & Neglect, 7, 2948.CrossRefGoogle Scholar
Cherry, R.L. (1991). Agents of nursing home quality of care: ombudsmen and staff ratios revisited. The Gerontologist, 31, 302308.CrossRefGoogle ScholarPubMed
Cherry, R.L. (1993). Community presence and nursing home quality of care: the ombudsman as a complementary role. Journal of Health and Social Behavior, 34, 336345.CrossRefGoogle ScholarPubMed
Davies, A.R., & Ware, J.E. (1988). Involving consumers in quality of care assessment. Health Affairs (Milwood), 7, 3348.CrossRefGoogle ScholarPubMed
Davis, M.A. (1991). On nursing home quality: a review and analysis. Medical Care Review, 48, 129166.CrossRefGoogle Scholar
Flood, A.B. (1990). Peaks and pits of using large data bases to measure quality of care. International Journal of Technology Assessment in Health Care, 6, 253262.CrossRefGoogle ScholarPubMed
Institute of Medicine. (1986). Improving the quality of care in nursing homes. Washington DC: National Academy Press.Google Scholar
Johnson-Pawlson, J., & Infeld, D.L. (1996). Nurse staffing and quality of care in nursing facilities. Journal of Gerontological Nursing, 22, 3645.CrossRefGoogle ScholarPubMed
Kane, R.A., & Kane, R.L. (1988). Long-term care: Variations on a quality assurance theme. Inquiry, 25, 132146.Google ScholarPubMed
Karuza, J., & Katz, P.R. (1994). Physician staffing patterns correlates of nursing home care: an initial inquiry and consideration of policy implications. Journal of the American Geriatrics Society, 42, 787793.CrossRefGoogle ScholarPubMed
Litwin, H., & Monk, A. (1987). Do nursing home patient ombudsmen make a difference? Journal of Gerontological Social Work, 11, 95104.CrossRefGoogle Scholar
Moore, E.G., Rosenberg, M.W., & McGuinness, D. (1997). Growing old in Canada: demographic and geographic perspectives. Ottawa: Statistics Canada.Google Scholar
Morris, J.N., Hawes, C, Fries, B.E., Phillips, C.D., Mor, V., Katz, S., Murphy, K, Drugovich, M.L., & Friedlob, A.S. (1990). Designing the national resident assessment instrument for nursing homes. The Gerontologist, 30, 293307.CrossRefGoogle ScholarPubMed
Muir Gray, J.A., Almind, G., Freer, C, & Warshaw, G. (1985). Screening and case finding. In Muir, J.A. Gray (Ed.), Prevention of disease in the elderly (pp. 5163). New York: Churchill Livingstone.Google Scholar
Nyman, J.A. (1989). Excess demand, consumer rationality, and the quality of care in regulated nursing homes. Health Services Research, 24, 105127.Google ScholarPubMed
Pearson, A., Hocking, S., Mott, S., & Riggs, A. (1993). Quality of care in nursing homes: from the resident's perspective. Journal of Advanced Nursing, 18, 2024.CrossRefGoogle ScholarPubMed
Phillips, C.J. (1991). Developing a method of assessing quality of care in nursing homes, using key indicators and population norms. Journal of Aging and Health, 3, 407422.CrossRefGoogle ScholarPubMed
Phillips, L.R., Morrison, E.F., & Chae, Y.M. (1990a). The QUALCARE Scale: developing an instrument to measure quality of care. International Journal of Nursing Studies, 27, 6175.CrossRefGoogle Scholar
Phillips, L.R., Morrison, E.F., & Chae, Y.M. (1990b). The QUALCARE Scale: testing of a measurement instrument for clinical practice. International Journal of Nursing Studies, 27, 7791.CrossRefGoogle ScholarPubMed
Pillemer, K. (1988). Maltreatment of patients in nursing homes: overview and research agenda. Journal of Health and Social Behavior, 29, 227238.CrossRefGoogle ScholarPubMed
Rantz, M.J., Petroski, G.F., Madsen, R.W., Scott, J., Mehr, D.R., Popejoy, L., Hicks, L.L., Porter, R., Zwygart-Stauffacher, M., & Grando, V. (1997). Setting thresholds for MDS quality indicators for nursing home quality improvement reports. The Joint Commission Journal on Quality Improvement, 23, 602611.CrossRefGoogle ScholarPubMed
Rubin, H.R., & Wu, A.W. (1992). The risk of adjustment. Medical Care, 30, 973975.Google ScholarPubMed
Shah, B.V., Barnwell, B.G., & Bieler, G.S. (1996). SUDAAN, software for the analysis of correlated data: user's manual. Release 7.0. Research Triangle Park, NC: Research Triangle Institute.Google Scholar
Shapiro, E., & Tate, R.B. (1995). Monitoring the outcomes of quality of care in nursing homes using administrative data. Canadian Journal on Aging, 14(4), 755768.CrossRefGoogle Scholar
Spector, W.D., & Mukamel, D.B. (1998). Using outcomes to make inferences about nursing home quality. Evaluation & the Health Professions, 21, 291315.CrossRefGoogle ScholarPubMed
Spencer, C. (1994). Abuse and neglect of older adults in institutional settings: A discussion paper building from English language resources. Ottawa: Health Canada.Google Scholar
Sundram, C. (1984). Obstacles to reducing patient abuse in public institutions. Hospital and Community Psychiatry, 35, 238243.Google ScholarPubMed
U.S. General Accounting Office. (1989). Board and care: Insufficient assurances that residents' needs are identified and met. Gaithersburg, MD: Report to Congressional requesters GAO/HRD-89–50.Google Scholar
Zimmerman, D.R., Karon, S.L., Arling, G., Ryther-Clark, B., Collins, T., Ross, R., & Sainfort, F. (1995). Development and testing of nursing home quality indicators. Health Care Financing Review, 16, 107127.Google ScholarPubMed
Zinn, J.S., Aaronson, W.E., & Rosko, M.D. (1993). The use of standardized indicators as quality improvement tools: An application in Pennsylvania nursing homes. American Journal of Medical Quality, 8, 7278.CrossRefGoogle ScholarPubMed