Racial and ethnic differences in access to and utilization of nursing home care continue to be of primary concern to policymakers. This is of particular relevance as the US elderly population becomes more racially and ethnically diverse. Nursing homes have not had the same organizational and financial pressures to desegregate as hospitals. As a result, the nursing home industry remains fairly segregated (Smith, 1990). There are concerns that nursing home segregation may affect quality of care, and that facilities exhibiting a high concentration of racial/ethnic minorities are characterized by poor outcomes of care.
This study examines the impact of race and ethnicity on nursing home quality of care. The sample consists of all nursing homes in 6 states: 5 states participating in HCFA's Case-Mix and Quality Demonstration (NY, MS, ME, KS, SD) and Ohio. Data are obtained from two sources: Minimum Data Set Plus (MDS+) resident assessment instrument and the On-line Survey Certification of Automated Records (OSCAR) file. Data are analyzed using ordinary least squares regression to test a model of nursing home quality as a function of the facility's proportion of racial/ethnic minorities. Seven risk-adjusted outcome measures are used as quality indicators: cognitive decline, pressure ulcers (incidence and prevalence), ADL decline, prevalence of daily physical restraints, mood decline, antipsychotic drug use, and social engagement decline. Organizational characteristics included as control variables are size, ownership, chain affiliation, and proportion of Medicaid residents. Policy implications of the findings are discussed.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1. Assess the impact of race/ethnicity on nursing home quality 2. Discuss the implications of racial/ethnic concentration for nursing home quality of care 3. Understand different outcomes used as indicators of nursing home quality
Keywords: Ethnic Minorities, Nursing Homes
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.