Institutional and individual factors associated with functional outcomes in nursing home residents under long-term care insurance in Korea: A multilevel analysis

Objective: The purpose of this study was to analyze the relationship between institutional and individual characteristics that influence changes in the functional outcomes of nursing home residents. Methods: Long-term Care Insurance claims data with basic information of nursing home(n = 3,263) and longterm care needs assessment data of nursing home residents(n = 34,717) was used. The independent variable was classified into individual (level 1) and nursing home characteristics (level 2). Changes in physical function, cognitive function, and behavioral symptoms were used as dependent variables. Results: The institutional factors of nursing homes contributed relatively little to substantial changes in function of nursing home residents. Ownership, size, and nursing home staff including care worker and physical/ occupational therapist were important determinants of functional changes in nursing home residents. Conclusion: To improve the quality of nursing homes in Korea, regulations on staffing should be modified, and an disincentive policy should be introduced for low-quality institutions. & COPY; 2023 Elsevier Inc. All rights reserved.