ArticleHealth services research2018
The Impact of Dementia Special Care Units on Quality of Care: An Instrumental Variables Analysis.
Article in Health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Pooled it
- A systematic review of specialty dementia care units in long-term care settings.International journal of geriatric psychiatry · 2023Pooled it
- Social interactions of persons with dementia living in special care units in long-term care: A mixed-methods systematic review.Dementia (London, England) · 2021Pooled it
- Definition and Measurement of Physical and Chemical Restraint in Long-Term Care: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Alzheimer's disease and related dementias in rural medicare populations: a scoping review.BMC geriatrics · 2026Article
- The National Dementia Workforce Study: Development of Questionnaires for Home Care, Assisted Living, and Nursing Home Settings.Journal of the American Geriatrics Society · 2025Article
- Medicaid Payments and Racial and Ethnic Disparities in Alzheimer Disease Special Care Units.JAMA network open · 2025Article
- The dementia care workforce: Essential to care but large research gaps exist.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Review
- Facility-Level Differences in Antipsychotic Drug Use: Impact on Quality Outcomes for Nursing Home Residents.Medical care · 2025Article
- Impact of skilled nursing facility quality on Medicare beneficiaries with dementia: Evidence from vacancies.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Organizational characteristics of highly specialized units for people with dementia and severe challenging behavior.BMC geriatrics · 2024Article
- Dementia, nurse staffing, and health outcomes in nursing homes.Health services research · 2024Article
- The symbiotic experiences of residents with and without dementia co-living in Taiwan's long-term care facilities: a phenomenological study.BMC geriatrics · 2024Article
- Impact of dementia special care units for short-stay nursing home patients.Journal of the American Geriatrics Society · 2024Article
- The relationship between preventive dental care and overall medical expenditures.The American journal of managed care · 2024Article
- Clinical Characteristics of Older Adults Living in Foster Families in the French West Indies: Baseline Screening of the KArukera Study of Aging in Foster Families (KASAF) Cohort.Innovation in aging · 2024Article
- Hospital Proximity and Emergency Department Use among Assisted Living Residents.Journal of the American Medical Directors Association · 2023Article
- Care delivery approaches and perceived barriers to improving quality of care: A national survey of skilled nursing facilities.Journal of the American Geriatrics Society · 2023Article
- What Can Economics Say about Alzheimer's Disease?Journal of economic literature · 2023Article
- Dementia Care Is Widespread In US Nursing Homes; Facilities With The Most Dementia Patients May Offer Better Care.Health affairs (Project Hope) · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectiveTo compare the quality of care following admission to a nursing home (NH) with and without a dementia special care unit (SCU) for residents with dementia. DATA SOURCES/STUDY
settingNational resident-level minimum dataset assessments (MDS) 2005-2010 merged with Medicare claims and provider-level data from the Online Survey, Certification, and Reporting database. STUDY
designWe employ an instrumental variable approach to address the endogeneity of selection into an SCU facility controlling for a range of individual-level covariates. We use "differential distance" to a nursing home with and without an SCU as our instrument. DATA COLLECTION/EXTRACTION
methodsMinimum dataset assessments performed at NH admission and every quarter thereafter. PRINCIPAL
findingsAdmission to a facility with an SCU led to a reduction in inappropriate antipsychotics (-9.7 percent), physical restraints (-9.6 percent), pressure ulcers (-3.3 percent), feeding tubes (-8.3 percent), and hospitalizations (-14.7 percent). We found no impact on the use of indwelling urinary catheters. Results held in sensitivity analyses that accounted for the share of SCU beds and the facilities' overall quality.
conclusionsFacilities with an SCU provide better quality of care as measured by several validated quality indicators. Given the aging population, policies to promote the expansion and use of dementia SCUs may be warranted.
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Registered trials
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