A systems framework for evaluating nursing care quality in nursing homes

    Authors

    L. Unruh;T. T. H. Wan

    Comments

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    Abbreviated Journal Title

    J. Med. Syst.

    Keywords

    nursing care quality; nursing home quality; systems framework; SPO; framework; RESIDENT ASSESSMENT INSTRUMENT; MULTIDIMENSIONAL THEORETICAL-MODEL; MEDICAID REIMBURSEMENT; HEALTH-CARE; CASE-MIX; STAFFING LEVELS; UNITED-STATES; OWNERSHIP; OUTCOMES; FACILITY; Health Care Sciences & Services; Medical Informatics

    Abstract

    Given the ongoing concerns about the quality of care in nursing homes, a theoretical framework to guide a systems approach to quality is important. Existing frameworks either do not model causality, or do so in a linear fashion in which the actual linkages between components of quality may not be well specified. Through a review of frameworks for nursing home quality, and empirical studies on the subject, the authors construct a framework for nursing home quality that links contextual components of quality with structure, structure with process, and process with outcomes, focusing on nursing care quality. Intrastructural relationships and feedback mechanisms are also modeled. The framework is matched with a discussion of multilevel structural equation analysis for statistical application. Future research should expand the framework to include non-nursing components of quality.

    Journal Title

    Journal of Medical Systems

    Volume

    28

    Issue/Number

    2

    Publication Date

    1-1-2004

    Document Type

    Article

    Language

    English

    First Page

    197

    Last Page

    214

    WOS Identifier

    WOS:000220764800008

    ISSN

    0148-5598

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