Caring labour, intersectionality and worker satisfaction: an analysis of the National Nursing Assistant Study (NNAS).

Caring labour in long-term care settings is increasingly important as the US population ages. Ethnographic research on nursing assistants (NAs) portrays nursing home care as routine and fast paced in facilities that emphasise life maintenance more than care. Recent interview-based and small quantitative studies describe a mix of positive and negative aspects of NA work, including the rewards of caring, despite shortcomings in working conditions and pay.

Applying a risk-adjustment framework to primary care: can we improve on existing measures?

Outcome-based performance measurement and prospective payment are common features of the current managed care environment. Increasingly, primary care clinicians and health care organizations are being asked to assume financial risk for enrolled patients based on negotiated capitation rates. Therefore, the need for methods to account for differences in risk among patients enrolled in primary care organizations has become critical.

Do different case-mix measures affect assessments of provider efficiency? Lessons from the Department of Veterans Affairs.

Although case-mix adjustment is critical for provider profiling, little is known regarding whether different case-mix measures affect assessments of provider efficiency. We examine whether two case-mix measures, Adjusted Clinical Groups (ACGs) and Diagnostic Cost Groups (DCGs), result in different assessments of efficiency across service networks within the Department of Veterans Affairs (VA). Three profiling indicators examine variation in resource use.

Profiling resource use: do different outcomes affect assessments of provider efficiency?

Objectives: To examine whether 2 outcome measures result in different assessments of efficiency across 22 service networks within the Department of Veterans Affairs (VA).

Study Design: A retrospective analysis using VA inpatient and outpatient administrative databases.

Methods: A 60% random sample of veterans who used healthcare services during fiscal year 1997 was split into a 40% sample (n = 1,046,803) for development and a 20% sample (n = 524,461) for validation.