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American Journal of Medical Quality
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Facility Effects on Racial Differences in Nursing Home Quality of Care

Mary L. Fennell, PhD

Brown University, Center for Gerontology and Health Care Research, Brown University, Providence, RI, Mary_Fennell{at}brown.edu

Susan C. Miller, PhD, MBA

Center for Gerontology and Health Care Research, Brown University

Vincent Mor, PhD

Center for Gerontology and Health Care Research, Brown University

This paper reviews the literature on racial/ethnic differences in nursing home quality, segregated access to nursing home care, and organizational and community factors that may influence access and quality of care. We present illustrative data on county demographics and the racial mix of African American residents in nursing homes in these counties for a sample of four states. We also briefly describe plans for multilevel modeling to test variation in racial/ethnic disparities in care as a function of nursing home structures and processes and community context.

Key Words: African Americans • ascertainment bias • disparities in care quality • multilevel model • nursing home client mix • nursing homes • population characteristics • quality indicators • racial/ethnic differences • segregation

American Journal of Medical Quality, Vol. 15, No. 4, 174-181 (2000)
DOI: 10.1177/106286060001500408


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