The Need for Higher Minimum Staffing Standards in U.S. Nursing Homes

被引：114

作者：

Harrington, Charlene ^{[1
]}

Schnelle, John F. ^{[2
,3
,4
,5
]}

McGregor, Margaret ^{[6
]}

Simmons, Sandra F. ^{[4
,5
,7
]}

机构：

[1] Univ Calif San Francisco, Dept Social & Behav Sci, Nursing & Sociol, San Francisco, CA 94143 USA

[2] Vanderbilt Univ, Dept Med, Div Geriatr, Med, Nashville, TN USA

[3] Vanderbilt Univ, Ctr Qual Aging, Div Geriatr, Dept Med, Nashville, TN USA

[4] Vanderbilt Univ, Div Gen Internal Med & Publ Hlth, Ctr Qual Aging, 221 Kirkland Hall, Nashville, TN 37235 USA

[5] Tennessee Valley Healthcare Syst, Dept Vet Affairs, Geriatr Res Educ & Clin Ctr, Nashville, TN USA

[6] Univ British Columbia, Community Geriatr, Dept Family Practice, Vancouver, BC, Canada

[7] Vanderbilt Univ, Dept Med, Div Geriatr, Nashville, TN USA

来源：

HEALTH SERVICES INSIGHTS | 2016年 / 9卷

关键词：

nurse staffing; nursing homes; standards; regulations; market incentives;

D O I：

10.4137/HSI.S38994

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Many U.S. nursing homes have serious quality problems, in part, because of inadequate levels of nurse staffing. This commentary focuses on two issues. First, there is a need for higher minimum nurse staffing standards for U.S. nursing homes based on multiple research studies showing a positive relationship between nursing home quality and staffing and the benefits of implementing higher minimum staffing standards. Studies have identified the minimum staffing levels necessary to provide care consistent with the federal regulations, but many U.S. facilities have dangerously low staffing. Second, the barriers to staffing reform are discussed. These include economic concerns about costs and a focus on financial incentives. The enforcement of existing staffing standards has been weak, and strong nursing home industry political opposition has limited efforts to establish higher standards. Researchers should study the ways to improve staffing standards and new payment, regulatory, and political strategies to improve nursing home staffing and quality.

引用

页码：13 / 19

页数：7

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