Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Decker FH [original query] |
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Experience and education of home health administrators and nursing home administrators and the relationship to establishment ownership
Decker FH , Decker SL . J Health Hum Serv Adm 2012 35 (2) 149-69 Administrators in long-term care may have an important influence on quality of care. Limited prior research has described the characteristics of nursing home administrators. Despite growing emphasis on home health care as an alternative to nursing homes, almost no research has described the characteristics of administrators of home health agencies. Using the 2004 National Nursing Home Survey and the 2007 National Home and Hospice Care Survey, we describe the career experience of administrators, and examine the relationship between experience and education of administrators both within and across the nursing home and home health sectors. We also explore the characteristics of nursing homes and home health agencies, including establishment ownership (e.g., nonchain not-for-profit), that are associated with being able to attract administrators with the most experience. We find that home health administrators have, on average, less experience than nursing home administrators. Among home health agencies, administrators with the least experience also tend to have less education. In nursing homes, administrators with less experience tend to have more education. Results from multivariate analysis suggest that chain for-profits may be the least able to attract experienced administrators. More research on the effects of different levels of experience and education among administrators is needed. |
Relationship of the job tenure of nursing home top management to the prevalence of pressure ulcers, pain, and physical restraint use
Decker FH , Castle NG . J Appl Gerontol 2011 30 (5) 539-561 The association of job tenure among nursing home administrators (NHAs) and directors of nursing (DONs) with the prevalence of pressure ulcers, pain, and physical restraint use was examined. Data sources included the 2004 National Nursing Home Survey and quality measures from the Centers for Medicare and Medicaid Services. Regression models examined NHA tenure (n = 787) and DON tenure (n = 703). Control variables included prior prevalence of the respective outcome, NHA/DON education, and facility characteristics among others. Increasing NHA and DON tenure were both associated with decreases in the prevalence of pressure ulcers and pain but not restraint use. DON tenure had more impact on outcomes in earlier stages of tenure than NHA tenure. Effects of NHA tenure were in later stages of tenure. Increasing tenure among NHAs and DONs may influence better resident outcomes within their facility. Southern Gerontological Society 2011. |
Profit status of home health care agencies and the risk of hospitalization
Decker FH . Popul Health Manag 2011 14 (4) 199-204 We examined the association of profit status and patient hospitalizations in the present-day home health care market, a market that grew substantially in the past decade, with much of that growth attributed to the entry of for-profit agencies. Data from the 2007 National Home and Hospice Care Survey were linked to the risk-adjusted agency-level measure of the percent of home health episodes of care ending in hospitalizations available from the Centers for Medicare and Medicaid Services' (CMS) Home Health Compare Web site. A linear regression model was estimated (n = 510). Control variables included other agency characteristics besides profit status, area hospital bed supply, and state dummy variables to control for state fixed effects. For-profit agencies were more likely than not-for-profit agencies to have a risk of hospitalizations greater than expected after accounting for patient characteristics and model control variables. Attributes of the CMS hospitalization measure are discussed and implications for future research described. |
Comparison of home health and hospice care agencies by organizational characteristics and services provided: United States, 2007
Park-Lee EY , Decker FH . Natl Health Stat Report 2010 (30) 1-23 OBJECTIVE: This report presents national estimates of the organizational characteristics of home health and hospice care agencies in 2007. Comparisons of organizational characteristics and provision of selected services are made by agency type. A comparison of selected characteristics between 1996 and 2007 is also provided to highlight changes that have occurred leading to the current composition of the home health and hospice care sector. METHODS: Estimates are based on data collected on agencies from the 1996, 2000, and 2007 National Home and Hospice Care Survey, conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. Estimates are derived from data collected during interviews with administrators and staff designated by the administrators. RESULTS: In 2007, there were 14,500 home health and hospice care agencies in the United States, an increase from 11,400 in 2000. Three-quarters of these agencies provided home health care only, 15% provided hospice care only, and 10% provided both home health and hospice care (mixed). The percentage of proprietary home health care only and hospice care only agencies increased during 1996-2007, whereas the percentage of proprietary mixed agencies remained relatively stable. The average number of home health care patients that home health care only and mixed agencies served decreased, while the average number of hospice care patients that hospice care only agencies served increased across years. Among mixed agencies, no significant changes were observed in the average number of hospice care patients being served. The percentage of home health care only agencies offering certain therapeutic and nonmedical services declined over the years. There was an increase in the proportion of hospice care only agencies' providing many core and noncore hospice care services during 1996-2007. Also during this time, the proportion of mixed agencies providing selected nonmedical services decreased. |
Trends in the prevalence and comorbidities of diabetes mellitus in nursing home residents in the United States: 1995-2004
Zhang X , Decker FH , Luo H , Geiss LS , Pearson WS , Saaddine JB , Gregg EW , Albright A . J Am Geriatr Soc 2010 58 (4) 724-30 OBJECTIVES: To estimate trends in the prevalence and comorbidities of diabetes mellitus (DM) in U.S. nursing homes from 1995 to 2004. DESIGN: SAS callable SUDAAN was used to adjust for the complex sample design and assess changes in prevalence of DM and comorbidities during the study period in the National Nursing Home Surveys. Trends were assessed using weighted least squares linear regression. Multiple logistic regressions were used to calculate predictive margins. SETTING: A continuing series of two-stage, cross-sectional probability national sampling surveys. PARTICIPANTS: Residents aged 55 and older: 1995 (n=7,722), 1997 (n=7,717), 1999 (n=7,809), and 2004 (n=12,786). MEASUREMENTS: DM and its comorbidities identified using a standard set of diagnosis codes. RESULTS: The estimated crude prevalence of DM increased from 16.9% in 1995 to 26.4% in 2004 in male nursing home residents and from 16.1% to 22.2% in female residents (all P<.05). Male and female residents aged 85 and older and those with high functional impairment showed a significant increasing trend in DM (all P<.05). In people with DM, multivariate-adjusted prevalence of cardiovascular disease increased from 59.6% to 75.4% for men and from 68.1% to 78.7% for women (all P<.05). Prevalence of most other comorbidities did not increase significantly. CONCLUSION: The burden of DM in residents of U.S. nursing homes has increased since 1995. This could be due to increasing DM prevalence in the general population or to changes in the population that nursing homes serve. Nursing home care practices may need to change to meet residents' changing needs. |
Intrinsic job satisfaction, overall satisfaction, and intention to leave the job among nursing assistants in nursing homes
Decker FH , Harris-Kojetin LD , Bercovitz A . Gerontologist 2009 49 (5) 596-610 PURPOSE: We examined predictors of intrinsic job satisfaction, overall satisfaction, and intention to leave the job among nursing assistants (NAs). DESIGN AND METHODS: The study focused on NAs who worked 30 or more hours per week in a nursing home. Data on 2,146 NAs meeting this criterion came from the 2004 National Nursing Assistant Survey, the first telephone interview survey of NAs nationwide. Regression equations were calculated in which intrinsic satisfaction, overall satisfaction, and intention to leave were dependent variables. NA attributes (e.g., job tenure and education) and extrinsic job factors (e.g., assessment of supervisor behavior, pay satisfaction, and benefits) were exogenous variables. RESULTS: A positive assessment of the supervisor's behavior had the strongest association with intrinsic satisfaction. Pay satisfaction had the second strongest association with intrinsic satisfaction. Predictors with the strongest associations with intention to leave were overall and intrinsic satisfaction. Assessment of the supervisor was not associated directly with intention to leave. Assessments of the supervisor and pay may affect overall satisfaction and intention to leave in part through their direct effects on intrinsic satisfaction. Some facility and NA attributes were related to intrinsic satisfaction but not to overall satisfaction, suggesting that intrinsic satisfaction may be an intervening variable in the impact of these attributes on overall satisfaction. IMPLICATIONS: Intrinsic satisfaction and extrinsic job factors amenable to change appear central to NAs' overall satisfaction and intention to leave. A facility may be able to improve extrinsic job factors that improve NAs' job-related affects, including intrinsic satisfaction. |
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