Cost and Care Quality Between Licensed Nursing Homes Under Different Types of Ownership

Chun-Lan Lee；Ta-Li Liu；Ling-Jiuan Wu；Ue-Lin Chung；Li-Chuan Lee

nursing home ； own er ship ； cost ； qual ity of care

The Journal of Nursing Research

10卷2期（2002 / 06 / 01）

151 - 160

英文

In Taiwan, there is some uncertainty and concern regarding the quality and safety of unlicensed nursing homes, as they are typically crowded and poorly equipped. There are data insufficient regarding the quality of care in licensed nursing homes for the govemment to reliably assist unli censed facillties to become licensed. The purpose of this study was to examine the relation ship between the different nursing homeowner ship types and the following dependent vanables: (1) operating cost perresident day, (2) RN to resident ratio, (3) facility size, (4) occupancy rate, and (5) quality of care amongst licensed nursing homes nation wide. The descriptive study used a survey design. Data were obtained from 28 licensed nursing homes using self-administered question naires, on-site interviews and record reviews. Data were analyzed by Kruskal-Wallis test, Mann-Whitney U test and Spearman’s correlation. Apitive and significant relation ship existed between nursing home quality and the RN ratio perresident day. Chain/For-profit and Chain/Non-profit nursing homes tended to have higher operating costs and a better quality of ser vice. Secondary research is still needed to examine the results by detailed costanalysisor by research oriented toward outcomes of residents’ care. These findings provide basbre ference for the govemment for planning the operation of nursing home facilities and also to assist the many unlicensed nursing homes to ultimately become licensed. The results also present important data for developing reimbursement policies.

1. Anderson, R. A., Hsieh, P., Su, H.(1998).Resource Allocation and Resident Outcomes in Nursing Homes: Comparisons Between the Best and Worst.Research in Nursing ＆ Health,21(4)
2. Arling, G. R., Nordquist, H., Capitman, J. A.(1987).Nursing Home Cost and Ownership Type: Evidence of Interaction Effects.Health Service Research,22
3. Chang, C. H., Kao, S.(2000).Taipei, Taiwan,National Defense Medical Center.
4. Chang, L. K., Chiu, H. C.(1997).Kaohsiung, Taiwan,Kaohsiung Medical University.
5. Cherry, R. L.(1991).Agents of Nursing Home Quality of Care: Ombudsman and Staff Ratios Revised.Gerontologist,31(3)
6. Cohurn, A. F., Fortinsky, R., McGuire, C., McDonald, T. P.(1993).Effect of Prospective Reimbursement on Nursing Home Costs.Health Service Research,28
7. Davis, M. A.(1993).Nursing Home Ownership Revised: Market, Cost, and Quality Relationships.Medical Care,31
8. Davis, M. A., Freeman, J. W., Kirby, E. C.(1998).Nursing Home Performance Under Case-Mix Reimbursement: Responding to Heavy-Care Incentive Market Changes.Health Service Research, Pt. 1,33(4)
9. Department of Health, The Executive Yuan(1997).Public Health Annual Report.Taipei:Department of Health, the Executive Yuan.
10. Department of Health, The Executive Yuan(2000).Public Health Annual Report.Taipei:Department of Health, the Executive Yuan.
11. Felton, B. B.(1993).How Organization of Nursing Care and Resident Health Status Affect Nursing Home Cost.Nursing Outlook,41
12. Holmes, J. S.(1992).Institutional form and the Nursing Home Industry: Ownership Effects on Costs and Quality.
13. Lee, A. J., Birnbaum, H., Bishop, C.(1983).How a Nursing Home Behaves: A Multi-Equation Model of Nursing Home Behavior.Social Science and Medicine,17
14. Li, W. L.(2000).Taipei, Taiwan,National Defense Medical Center.
15. McKay, N. L.(1991).The Effect of Chain Ownership on Nursing Home Cost.Health Service Research,26
16. Mosley, C. B.(1994).Nursing Home Ownership and Quality of Care.Journal of Applied Gerontology,13
17. Munroe, D. J.(1990).The Influence of Registered Nurse Staffing on the Quality of Nursing Home Care.Research in Nursing and Health,13
18. Nyman, J. A.(1988).Improving the Quality of Nursing Home Outcomes.Medical Care,26
19. Rantz, M. J., Mehr, D. R., Popejoy, L., Zwygart-Stauffacher, M., Hicks, L. L., Grando, V., Conn, V. S., Porter, R., Scott, J., Maas, M.(1998).Nursing Home Care Quality: A Multidimensional Theoretical Model.Journal of Nursing Care Quality,12(3)
20. Shaughnessy, P., Schlenker, R., Brown, K., Yslas, I.(1983).Case Mix and Surrogate Indicators of Quality of Care Over Time in Freestanding and Hospital-Based Nursing Homes in Colorado.Public Health Reports,98
21. Wu, S. C.(1999).Evaluation and Suggestions on Long-Term Care System.Welfare Society,12(3)
22. Yang, C. L.(1999).The Quality Cares Indicators of Nursing Homes.Chang-Kang Nursing Research,7(2)
23. 尹祚芊 Yin, Teresa Joe-Chen(1999)。我國長期照護機構需求殷切之原因 Rationale of the Urgent Need of the Long-Term Care Institutions in Taiwan。榮總護理 VGH Nursing，16(1)

1. 葉淑娟(2006)。組織特質、管理風格、與長期照護品質之關係。中山管理評論，14(3)，751-787。
2. (2021)。臺灣住宿型長照機構照顧服務員人力配置之研究。靜宜人文社會學報，15(2)，99-130。