Does the presence of a dementia special care unit improve nursing home quality?

J Aging Health. 2008 Oct;20(7):837-54. doi: 10.1177/0898264308324632.

Abstract

Objective: This study quantifies the effect of a new dementia special care unit (D-SCU) on the provision of care to all residents in a nursing home (NH).

Method: The authors use data from the On-line Survey Certification and Reporting system to identify free-standing NHs that first reported a D-SCU between 1996 and 2003 (N = 1,519). Fixed-effects models estimate the effect of a new D-SCU on the prevalence of each outcome (physical restraints, feeding tubes, and psychotropic medications) while controlling for secular trends.

Results: For all NHs, the use of physical restraints declined, the use of antipsychotics increased, and other measures remained relatively constant. The introduction of a D-SCU was not associated with changes in trends for any measure.

Discussion: Differences in care processes between NHs with and without D-SCUs are the result of differences in their underlying approach to care, not the result of care practice diffusion from the D-SCU.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Anxiety Agents / therapeutic use
  • Antipsychotic Agents / therapeutic use
  • Delivery of Health Care / trends*
  • Dementia / therapy*
  • Enteral Nutrition / statistics & numerical data
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Nursing Homes / organization & administration*
  • Outcome Assessment, Health Care / trends
  • Quality of Health Care / trends*
  • Restraint, Physical / statistics & numerical data
  • Specialties, Nursing / organization & administration*
  • United States

Substances

  • Anti-Anxiety Agents
  • Antipsychotic Agents
  • Hypnotics and Sedatives