ArticleJournal of the American Medical Directors Association2020
Quality of Nursing Homes and Admission of Residents With Alzheimer's Disease and Related Dementias: The Potential Influence of Market Factors and State Policies.
Article in Journal of the American Medical Directors Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- Telemedicine Utilization Among Residents With Alzheimer Disease and Related Dementia: Association With Nursing Home Characteristics.Journal of the American Medical Directors Association · 2024Observational
- Source-Specific Air Pollution and Loss of Independence in Older Adults Across the US.JAMA network open · 2024Article
- Dying with dementia in nursing homes: A population-based study of decedents and their families.Journal of the American Geriatrics Society · 2024Article
- Home health services for minorities in urban and rural areas with Alzheimer's and related dementia.Home health care services quarterly · 2023Article
- Post-acute care transitions and outcomes among Medicare beneficiaries with dementia: Associations with race/ethnicity and dual status.Health services research · 2023Observational
- Variability and Potential Determinants of Assisted Living State Regulatory Stringency.Journal of the American Medical Directors Association · 2021Observational
- Racial disparity in end-of-life hospitalizations among nursing home residents with dementia.Journal of the American Geriatrics Society · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesThis study aimed to examine the associations between nursing home (NH) quality and prevalence of newly admitted NH residents with Alzheimer's disease and related dementias (ADRD), and to assess the extent to which market-level wages for certified nursing assistants (CNAs) and state Medicaid behavioral and mental health add-on policy may influence such associations.
designRetrospective cohort study. SETTING AND
participantsThe analytical sample included 2777 NHs with either high or low quality, located in urban areas of 41 states from 2011 to 2014.
methodsThe outcome variable was the prevalence of ADRD among newly admitted NH residents. NH quality was defined as dichotomous, based on the Nursing Home Compare (NHC) star rating system. We considered an NH with 5-star rating as having high quality and with 1-star rating as having low quality. Information on county-level CNA wages and state Medicaid behavioral and mental health add-on policies was included. Linear regression models with NH random effects and robust standard errors were estimated. A set of sensitivity analyses were performed.
resultsAfter accounting for NH-level aggregated resident characteristics and market/state-level factors, the prevalence of ADRD among newly admitted residents was 3% lower in high-quality NHs compared with low-quality NHs (P < .01). A 1-dollar increase in CNA hourly wage was associated with a 0.9-percentage point decrease in the prevalence of ADRD among newly admitted residents (P < .01). State Medicaid behavioral and mental health add-on policy was associated with a 2.5-percentage point increase in the prevalence of ADRD in high-quality NHs (P < .05), but not in low-quality NHs. CONCLUSIONS AND IMPLICATIONS: Our findings suggest that high-quality NHs are less likely to admit residents with ADRD. The effect size of this relationship is modest and may be influenced by state Medicaid behavioral and mental health add-on policies. Future studies are needed to better understand reasons leading to these associations so that effective interventions can be developed to incentivize high-quality NHs to more readily serve residents with ADRD.
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