Quality of care and mortality among long-term care residents with dementia.

摘要

This study assesses the effect of care quality on the risk of mortality among long-term care residents with dementia using secondary data. Data were drawn from the Intermediate Care Facility Project, conducted by the Centre on Aging, University of Victoria. The study involved 510 residents in 77 facilities throughout British Columbia. Mortality data were obtained from BC Vital Statistics for the twelve month observation period; which were collected as part of the Intermediate Care Facility Project. Care quality was measured along six dimensions: physical environment; non-use of physical restraints; non-use of pharmacological restraints; staff education and training; flexibility of care; and pre-admission and admission procedures. Data for these dimensions were collected at admission and again after twelve months. Statistical analyses involved cross-tabulations, bivariate correlations, logistic and Cox regressions. Substantively, the study found that resident characteristics such as age, gender and physical disability were more important than social causation variables (such as staff education and physical environment) in explaining risk of death. Among the social causative factors hypothesized to affect mortality, only facility use of physical restraints was important. Residents in facilities that used more types of physical restraints tended to be at higher risk of death than residents in facilities that used fewer or no physical restraints. It is concluded that more research into measurement of the social causative factors is required before making any definitive conclusions about what influences mortality among those persons with dementia who live in long-term care facilities in British Columbia.