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Facility staffing associated with potentially avoidable hospitalizations in nursing home residents in Japan: a retrospective cohort study
BACKGROUND: Wide variations in facility staffing may lead to differences in care, and consequently, adverse outcomes such as hospitalizations. However, few studies focused on types of occupations. Therefore, we aimed to examine the association between a wide variety of facility staffing and potentia...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10504825/ https://www.ncbi.nlm.nih.gov/pubmed/37715180 http://dx.doi.org/10.1186/s12877-023-04278-2 |
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author | Hamasaki, Yoko Sakata, Nobuo Jin, Xueying Sugiyama, Takehiro Morita, Kojiro Uda, Kazuaki Matsuda, Shinya Tamiya, Nanako |
author_facet | Hamasaki, Yoko Sakata, Nobuo Jin, Xueying Sugiyama, Takehiro Morita, Kojiro Uda, Kazuaki Matsuda, Shinya Tamiya, Nanako |
author_sort | Hamasaki, Yoko |
collection | PubMed |
description | BACKGROUND: Wide variations in facility staffing may lead to differences in care, and consequently, adverse outcomes such as hospitalizations. However, few studies focused on types of occupations. Therefore, we aimed to examine the association between a wide variety of facility staffing and potentially avoidable hospitalizations of nursing home residents in Japan. METHODS: In this retrospective cohort study using long-term care and medical insurance claims data in Ibaraki Prefecture from April 2018 to March 2019, we identified individuals aged 65 years and above who were newly admitted to nursing homes. In addition, facility characteristic data were obtained from the long-term care insurance service disclosure system. Subsequently, we conducted a multivariable Cox regression analysis and evaluated the association between facility staffing and potentially avoidable hospitalizations. RESULTS: A total of 2909 residents from 235 nursing homes were included. The cumulative incidence of potentially avoidable hospitalizations at 180 days was 14.2% (95% confidence interval [CI] 12.7–15.8). Facilities with full-time physicians (adjusted hazard ratio [HR]: 0.59, 95% CI: 0.37–0.94) and a higher number of dietitians (HR: 0.72, 95% CI: 0.54–0.97) were significantly associated with a lower likelihood of potentially avoidable hospitalizations. In contrast, having nurses or trained caregivers during the night shift (HR: 1.72, 95% CI: 1.25–2.36) and a higher number of care managers (HR: 1.37, 95% CI: 1.03–1.83) were significantly associated with a high probability of potentially avoidable hospitalizations. CONCLUSIONS: We revealed that variations in facility staffing were associated with potentially avoidable hospitalizations. The results suggest that optimal allocation of human resources, such as dietitians and physicians, may be essential to reduce potentially avoidable hospitalizations. To provide appropriate care to nursing home residents, it is necessary to establish a system to effectively allocate limited resources. Further research is warranted on the causal relationship between staff allocation and unnecessary hospitalizations, considering the confounding factors. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-023-04278-2. |
format | Online Article Text |
id | pubmed-10504825 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-105048252023-09-17 Facility staffing associated with potentially avoidable hospitalizations in nursing home residents in Japan: a retrospective cohort study Hamasaki, Yoko Sakata, Nobuo Jin, Xueying Sugiyama, Takehiro Morita, Kojiro Uda, Kazuaki Matsuda, Shinya Tamiya, Nanako BMC Geriatr Research BACKGROUND: Wide variations in facility staffing may lead to differences in care, and consequently, adverse outcomes such as hospitalizations. However, few studies focused on types of occupations. Therefore, we aimed to examine the association between a wide variety of facility staffing and potentially avoidable hospitalizations of nursing home residents in Japan. METHODS: In this retrospective cohort study using long-term care and medical insurance claims data in Ibaraki Prefecture from April 2018 to March 2019, we identified individuals aged 65 years and above who were newly admitted to nursing homes. In addition, facility characteristic data were obtained from the long-term care insurance service disclosure system. Subsequently, we conducted a multivariable Cox regression analysis and evaluated the association between facility staffing and potentially avoidable hospitalizations. RESULTS: A total of 2909 residents from 235 nursing homes were included. The cumulative incidence of potentially avoidable hospitalizations at 180 days was 14.2% (95% confidence interval [CI] 12.7–15.8). Facilities with full-time physicians (adjusted hazard ratio [HR]: 0.59, 95% CI: 0.37–0.94) and a higher number of dietitians (HR: 0.72, 95% CI: 0.54–0.97) were significantly associated with a lower likelihood of potentially avoidable hospitalizations. In contrast, having nurses or trained caregivers during the night shift (HR: 1.72, 95% CI: 1.25–2.36) and a higher number of care managers (HR: 1.37, 95% CI: 1.03–1.83) were significantly associated with a high probability of potentially avoidable hospitalizations. CONCLUSIONS: We revealed that variations in facility staffing were associated with potentially avoidable hospitalizations. The results suggest that optimal allocation of human resources, such as dietitians and physicians, may be essential to reduce potentially avoidable hospitalizations. To provide appropriate care to nursing home residents, it is necessary to establish a system to effectively allocate limited resources. Further research is warranted on the causal relationship between staff allocation and unnecessary hospitalizations, considering the confounding factors. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-023-04278-2. BioMed Central 2023-09-15 /pmc/articles/PMC10504825/ /pubmed/37715180 http://dx.doi.org/10.1186/s12877-023-04278-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Hamasaki, Yoko Sakata, Nobuo Jin, Xueying Sugiyama, Takehiro Morita, Kojiro Uda, Kazuaki Matsuda, Shinya Tamiya, Nanako Facility staffing associated with potentially avoidable hospitalizations in nursing home residents in Japan: a retrospective cohort study |
title | Facility staffing associated with potentially avoidable hospitalizations in nursing home residents in Japan: a retrospective cohort study |
title_full | Facility staffing associated with potentially avoidable hospitalizations in nursing home residents in Japan: a retrospective cohort study |
title_fullStr | Facility staffing associated with potentially avoidable hospitalizations in nursing home residents in Japan: a retrospective cohort study |
title_full_unstemmed | Facility staffing associated with potentially avoidable hospitalizations in nursing home residents in Japan: a retrospective cohort study |
title_short | Facility staffing associated with potentially avoidable hospitalizations in nursing home residents in Japan: a retrospective cohort study |
title_sort | facility staffing associated with potentially avoidable hospitalizations in nursing home residents in japan: a retrospective cohort study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10504825/ https://www.ncbi.nlm.nih.gov/pubmed/37715180 http://dx.doi.org/10.1186/s12877-023-04278-2 |
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