Does Quality Influence Consumer Choice of Nursing Homes to Nursing Home Transfers;Final rept

摘要

Although nursing home residents may benefit from transferring when a different facility could better meet their needs, such transfers have received little attention. We use MDS assessments from four states to test whether residents and their proxies respond to quality of care by changing providers. Cox proportional hazards models for time to transfer were estimated to determine which variables influenced the likelihood of transfer. Sociodemographic factors that increased the likelihood of transfers included younger age, male gender, white race, married, and Medicare payment source. Transfers were less likely among residents who had a terminal prognosis or an advance directive. Indicators of poor quality increased likelihood of transfer (receipt of antipsychotic/hypnotic medications, urinary tract infection, worsening pressure ulcers, deteriorating social engagement, lower staffing, and more deficiencies in state inspections). Residents of for-profit homes or homes with excess capacity were more likely to transfer.