Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Go to the ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Quality of Care for Veterans in Non VA Nursing Home

Laberge A, Weech-Maldonado R, Johnson CE, Jia H, Dewald L. Quality of Care for Veterans in Non VA Nursing Home. Poster session presented at: AcademyHealth Annual Research Meeting; 2006 Jun 25; Seattle, WA.




Abstract:

Objective: Over the past decade, veterans with long term care needs have been increasingly admitted to state veteran nursing homes and community nursing homes as opposed to VA nursing homes. There are no studies that have examined the difference in the quality of care between the community nursing home and the state veteran nursing homes. Using Donabedian's structure, process, and outcomes framework for quality assessment, this study compares the quality of care of community nursing homes with veterans (VCNH), state veteran homes (SVNH), and community nursing homes without veterans (CNH) in an effort to determine which among these facilities best serve veterans. Methods: In a retrospective observational cohort study, the study uses facility level data from the 1999-2002 Online Survey Certification and Reporting (OSCAR). Structural measures of quality include whether a facility met CMS recommended staffing levels for certified nursing assistants (CNAs) and registered nurses (RNs). Process measures of quality include the proportion of residents that required tube feeding, new catheterization, and mobility restraints. Outcome measures of quality include quality of care deficiencies, quality of life deficiencies, total deficiencies, actual harm citations, and proportion of residents with new pressure sores. Analysis of variance was used to test quality differences across the three different sites of care. Findings: Structure: Significantly more state veteran nursing homes (SVNH) met CMS standard levels for CNAs (p < .01) and RNs (p < .05) than either community nursing homes without veterans (CNH) or Community nursing homes with veterans (VCNH) (n = 6823). Significantly more CNH met CMS standard levels for CNAs (p < .01) and RNs (p < .01) than VCNH. Process: SVNH and CNH had significantly less tube feeds (p < .01) than VCNH, VCNH had significantly less tube feeds (p < .01) than CNH. CNH and VCNH had significantly less new catheters (p > .01) than SVNH, and CNH had significantly more restraints (p > .01) than VCNH. Outcomes: CNH had significantly less (p < .01) quality of care deficiencies (p > .01), quality of life deficiencies (p > .01), total deficiencies (p > .01) and actual harm citations (p > .01) than VCNH. SVNH had significantly less quality of care deficiencies (p > .01) and total deficiencies (p > .01) than VCNH. Conclusions: The quality of care in state veteran nursing homes (SVNH) was at a level that was comparable to that of community nursing homes (CNH) that did not have veterans. Both SVNH and CNH provided relatively better quality of care when compared to community nursing homes with veterans.





Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.