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"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
The role of ownership in the provision of nursing home care has long been a challenging issue for policymakers and researchers. Historically, much of the focus in this area has been on for-profit providers, which have played a prominent role in the nursing home sector for decades. Nearly two-thirds of facilities in the United States currently operate on a proprietary basis, and many of these facilities operate as part of multi-facility chains. In the context of recurring quality of care problems, the role of for-profit companies has often been investigated as a possible contributing factor, and a large body of research has compared care delivered by for-profit and not-for-profit facilities.
Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.
Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.
The overall objective of this research was to analyze the effect of ownership status on 1) quality of care delivered, 2) the cost of nursing homes in the United States and 3) wages to Registered Nurses. The model developed here uses a two stage least squares technique to correct for observed endogeneity problems. Results show that a model which includes ownership classification interactively with all independent variables, performs better than a model which simply uses dummies to proxy for ownership status. Nonprofit homes were found to have higher direct patient care expenditures than profit homes. Non-profits were also found to have a more specialized nursing force. Both of these results suggest that non-profits may actually provide a higher quality of care than for profit enterprises. No support was found for the hypothesis that nonprofits have more philanthropic wage policies.
A leading public-health expert brings to light the shocking conditions in America's nursing homes today and pinpoints the tragic mistakes in public policy that have contributed toward producing these conditions.
An in-depth analysis of the nursing home industry in America -- its past, present, and future. It focuses on the business aspects of the industry, and provides a detailed examination of the main issues concerning all nursing homes -- trends in health care expenditures; the legislative history of the industry; growing demand for care and how to measure it; the present structure of the industry; funding and financing concerns; government regulation; inter-industry competition and opportunities for growth; global comparisons; and public policy considerations.