This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Berlowitz, D. R. Articles by Moskowitz, M. A. Search for Related Content PubMed PubMed Citation Articles by Berlowitz, D. R. Articles by Moskowitz, M. A. Social Bookmarking                         What's this?

Pressure Ulcer Development in the VA: Characteristics of Nursing Homes Providing Best Care

Center for Health Quality, Outcomes, and Economic Research, Bedford VA Hospital, Bedford, Mass, Boston University Schools of Medicine and Public Health, Boston, Mass

Jennifer J. Anderson, PhD

Center for Health Quality, Outcomes, and Economic Research, Bedford VA Hospital, Bedford, Mass, Boston University Schools of Medicine and Public Health, Boston, Mass

Gary H. Brandeis, MD

Center for Health Quality, Outcomes, and Economic Research, Bedford VA Hospital, Bedford, Mass, Boston University Schools of Medicine and Public Health, Boston, Mass

Laura A. Lehner, PhD

Management Science Group, Bedford VA Hospital, Bedford, Mass, Boston University Schools of Medicine and Public Health, Boston, Mass

Harriet K. Brand, MPH

Center for Health Quality, Outcomes, and Economic Research, Bedford VA Hospital, Bedford, Mass, Boston University Schools of Medicine and Public Health, Boston, Mass

Arlene S. Ash, PhD

Health Care Research Unit, Boston Medical Center, Boston, Mass, Boston University Schools of Medicine and Public Health, Boston, Mass

Mark A. Moskowitz, MD

Health Care Research Unit, Boston Medical Center, Boston, Mass, Boston University Schools of Medicine and Public Health, Boston, Mass

This study identifies structural characteristics of VA nursing homes that are associated with the best patient outcomes. We evaluated risk-adjusted rates of pressure ulcer development in VA nursing homes and related these rates to facility size, staffing patterns, teaching nursing home status, and rural versus urban locale. Higher rates of pressure ulcer development were seen among urban teaching nursing homes and among nursing homes associated with both larger and smaller VA hospitals. Staffing patterns had a complex association with pressure ulcer development, and smaller nursing home staffs were not clearly associated with higher rates. For multivariate modeling, only hospital size and staffing remained significant independent predictors of pressure ulcer development. These results emphasize that while structural characteristics of VA nursing homes can provide insights about care, improving the quality of care in this setting will require a much greater understanding of how nursing homes are organized to meet patient needs.

American Journal of Medical Quality, Vol. 14, No. 1, 39-44 (1999)
DOI: 10.1177/106286069901400106


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				N. G. Castle Nursing Home Caregiver Staffing Levels and Quality of Care: A Literature Review Journal of Applied Gerontology, August 1, 2008; 27(4): 375 - 405. [Abstract] [PDF]

				N. M. Bellows and H. A. Halpin MDS-Based State Medicaid Reimbursement and the ADL-Decline Quality Indicator Gerontologist, June 1, 2008; 48(3): 324 - 329. [Abstract] [Full Text] [PDF]

				D. R. Thomas Issues and Dilemmas in the Prevention and Treatment of Pressure Ulcers: A Review J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2001; 56(6): M328 - M340. [Abstract] [Full Text] [PDF]