Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #108952

Akiko Kamimura, Health Management and Policy, University of Michigan, 109. S. Observatory, Ann Arbor, MI 48109-2029, 734-222-4033, kamimura@umich.edu

The competition among long-term care facilities for the elderly in the market is gaining in importance as the number of the elderly is increasing rapidly in developed countries. Japanese nursing homes face competition in the market for resources but not for residents because the demand for nursing home care exceeds supply. This study examines how the organizational density in the market affects quality in Tokyo nursing homes. Data were obtained from inspection results, publications and documents issued by the Tokyo Metropolitan Government in 2004. The data include 319 nursing homes, after excluding those in villages and islands, which equals approximately 92 % of all nursing homes in Tokyo. Statistical analysis was conducted using hierarchical linear models which were implemented using SAS PROC MIXED. This study affirms that the number of other nursing homes, similar types of facilities, and hospitals in the city are associated with quality in nursing homes in some aspects such as provision of care staff and availability of medical services. In other aspects such as the percentage of private rooms and inspection results, factors which affect the quality were mostly at the facility level. This study also found some evidence for the negative influence of the number of facilities in the market on quality. This study is useful for policy because it gives an understanding of the impact of competition for scare resources on quality in nursing home care.

Learning Objectives:

• Recognize the importance of the impact of organization density on quality of nursing homes when the demand for nursing home care exceeds supply.
• Apply to other regions which face the unbalanced demand and supply for nursing homes care.
• Develop potential policy solutions for improving quality of nursing homes care when the demand for nursing home care exceeds supply.

Keywords: Nursing Home Markets,

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.