Objective: To test the hypothesis that more stringent quality regulations contribute to better quality nursing home care and to assess their cost-effectiveness.
Data Sources/setting: Primary and secondary data from all states and U.S. nursing homes between 2005 and 2006.
Study Design: We estimated seven models, regressing quality measures on the Harrington Regulation Stringency Index and control variables. To account for endogeneity between regulation and quality, we used instrumental variables techniques. Quality was measured by staffing hours by type per case-mix adjusted day, hotel expenditures, and risk-adjusted decline in activities of daily living, high-risk pressure sores, and urinary incontinence.
Data Collection: All states' licensing and certification offices were surveyed to obtain data about deficiencies. Secondary data included the Minimum Data Set, Medicare Cost Reports, and the Economic Freedom Index.
Principal Findings: Regulatory stringency was significantly associated with better quality for four of the seven measures studied. The cost-effectiveness for the activities-of-daily-living measure was estimated at about 72,000 in 2011/ Quality Adjusted Life Year.
Conclusions: Quality regulations lead to better quality in nursing homes along some dimensions, but not all. Our estimates of cost-effectiveness suggest that increased regulatory stringency is in the ballpark of other acceptable cost-effective practices.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513606 | PMC |
| http://dx.doi.org/10.1111/j.1475-6773.2012.01459.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Primary regulatory T cell activator FOXP3 is present across Amphibia.
Immunogenetics
February 2025
Department of Integrative Biology, The University of Texas at Austin, Austin, TX, USA.
The overall structure of the immune system is highly conserved across jawed vertebrates, but characterization and description of the immune system is heavily biased toward mammals. One arm of the vertebrate immune system, the adaptive immune system, mounts pathogen-specific responses that tend to be robust and effective at clearing pathogens. This system requires selection against self-recognition and modulation of the immune response.
View Article and Find Full Text PDFLeveraging stringency and lifecycle thinking to advance environmental sustainability in health technology regulation.
Health Aff Sch
February 2025
School of Environment, Enterprise and Development, University of Waterloo, Ontario, Canada, N2L 3G1.
Regulatory actors, particularly market authorization agencies, health technology assessment agencies, and health care procurement agencies, exert a powerful influence on the adoption and use of health technologies (eg, medicines and medical devices). With health care being responsible, directly and indirectly, for an estimated 4.6% of global greenhouse gas emissions, alongside other environmental harms, these actors have recognized the need to address the environmental impacts of health technologies.
View Article and Find Full Text PDFDynamic Outlier Slicing Allows Broader Exploration of Adaptive Divergence: A Comparison of Individual Genome and Pool-Seq Data Linked to Humic Adaptation in Perch.
Mol Ecol
January 2025
Institute of Freshwater Research, Department of Aquatic Resources (SLU Aqua), Swedish University of Agricultural Sciences, Drottningholm, Sweden.
How genetic variation contributes to adaptation at different environments is a central focus in evolutionary biology. However, most free-living species still lack a comprehensive understanding of the primary molecular mechanisms of adaptation. Here, we characterised the targets of selection associated with drastically different aquatic environments-humic and clear water-in the common freshwater fish, Eurasian perch (Perca fluviatilis).
View Article and Find Full Text PDFEarly childhood psychopathology and parental mental health during the COVID-19 pandemic: the effects of pandemic restrictions on 0- to 3-year-olds.
Front Child Adolesc Psychiatry
November 2024
Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany.
Introduction: The COVID-19 pandemic placed many restrictions on families and affected the mental health of parents and children. The present study examines how the restrictions imposed during the pandemic and parental mental health affect early childhood psychopathology.
Method: From September 2019 to December 2021, the Outpatient Department of Family Therapy at the Institute for Psychosocial Prevention, Heidelberg surveyed a clinical sample of 249 families who sought consultation for early childhood psychopathology.
Creating a System of Dual Regulation of Translation and Transcription to Enhance the Production of Recombinant Protein.
Biotechnol J
December 2024
School of Food Science and Pharmaceutical Engineering, Nanjing Normal University, Nanjing, Jiangsu, China.
When constructing cell factories, it is crucial to reallocate intracellular resources towards the synthesis of target compounds. However, imbalanced resource allocation can lead to a tradeoff between cell growth and production, reducing overall efficiency. Reliable gene expression regulation tools are needed to coordinate cell growth and production effectively.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!