Does profit status affect hospitalization and mortality rates in long-term care homes?
Bruyère Research Institute study sheds light
Ottawa, Ont., Sept 28, 2015 —
Today, the Bruyère Research Institute (BRI) announces the findings
of a new study which examines the differences in hospitalization and
mortality rates of residents newly admitted to Ontario long-term care (LTC)
homes (also known as nursing homes).
Published in the Journal of the American
Medical Directors Association, the research project included 53,739 residents
over a three-year period, from 2010 to 2012. Overall, the results indicate that
for-profit facilities have significantly higher hospitalization and mortality
rates than not-for-profit facilities. The study uses data housed at the
Institute for Clinical Evaluative Sciences.
Six months following admission, and following
adjustment for multiple factors at the individual and facility level, the
mortality rate in for-profit homes was 16 per cent higher, and the
hospitalization rate was 33 per cent higher in for-profit homes, than in
not-for-profit homes. During this period, residents in for-profit facilities
had an unadjusted hospitalization rate of 565 per 1,000 Person Years (PY) of
follow-up versus 416 per 1,000 PY in not-for-profit facilities. The
corresponding crude mortality rate in for-profit facilities was 252 per 1,000
PY versus 216 per 1,000 PY in not-for-profit facilities.
“Our results take advantage of a natural
experiment in Ontario, where the funding level and the characteristics of
residents in for-profit and not-for-profit homes are similar,” says
Dr. Peter Tanuseputro, research project lead at BRI and The Ottawa Hospital.
“The fact that the resident wait-list and placement system is also
standardized helps maintain this similarity.”
Of Ontario’s 640 long-term care homes,
384 (or 60 per cent) are for-profit facilities. However, regardless of their
profit status, all nursing homes receive standardized government funding for
each patient, which is set by a formal assessment of each resident’s
care needs.
“A facility’s profit status is
only one of many factors that affect hospitalization and mortality
rates,” states Dr. Tanuseputro. “Some for-profit facilities
are in the top 20 per cent of facilities that had the lowest rates of
hospitalization or mortality. Conversely, some not-for-profit facilities were
in the bottom 20 per cent. Other factors such as the size and location of a
facility are also important contributors.”
Previous literature suggested that differences in
resident outcomes may also depend on staffing levels, ease of access to
specialized medical services and additional sources of generated income such as
donations.
An accompanying online calculator uses the
study findings to predict the chance that a long-term care resident will die in
the six months after admission. It considers information such as a
person’s socio-demographics (e.g., age, sex and marital status), a
person’s health and the characteristics of the nursing home. This
calculator can be used by residents, their family members and/or caregivers to
inform care planning.
About the Bruyère Research
Institute
The Bruyère Research Institute is a
bilingual not-for-profit organization which partners with Bruyère and
the University of Ottawa to support researchers who contribute to relevant and
practical knowledge through programs of health research and programming related
to primary and community care, equity, cognition and mobility, health systems
and services, and promising practices.
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For more information, please
contact:
Stéphanie Girard
Director of Communications, Marketing
and Community Engagement
Bruyère
43 Bruyère St. Ottawa,
Ontario K1N 5C8
Cell.: 613-277-2526
sgirard@bruyere.org
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