Occupational Licensing of Social Services and Nursing Home Quality: A Regression Discontinuity Approach

ILR Review ◽  
2019 ◽  
Vol 74 (1) ◽  
pp. 199-223 ◽  
Author(s):  
John R. Bowblis ◽  
Austin C. Smith

Occupational licensing has grown dramatically in recent years, with more than 25% of the US workforce having a license as of 2008, up from 5% in 1950. Has licensing improved quality or is it simply rent-seeking behavior by incumbent workers? To estimate the impact of increased licensure of social workers in skilled nursing facilities (SNFs) on service quality, the authors exploit a federal staffing provision that requires SNFs of a certain size to employ licensed social workers. Using a regression discontinuity design, the authors find that qualified social worker staffing increases by approximately 10%. However, the overall increase in social services staffing is negligible because SNFs primarily meet this requirement in the lowest cost way—substituting qualified social workers for unlicensed social services staff. The authors find no evidence that the increase in licensure improves patient care quality, patient quality of life, or quality of social services provided.

2002 ◽  
Vol 32 (2) ◽  
pp. 315-325 ◽  
Author(s):  
Charlene Harrington ◽  
Steffie Woolhandler ◽  
Joseph Mullan ◽  
Helen Carrillo ◽  
David U. Himmelstein

Quality problems have long plagued the nursing home industry. While two-thirds of U.S. nursing homes are investor-owned, few studies have examined the impact of investor-ownership on the quality of care. The authors analyzed 1998 data from inspections of 13,693 nursing facilities representing virtually all U.S. nursing homes. They grouped deficiency citations issued by inspectors into three categories (“quality of care,” “quality of life,” and “other”) and compared deficiency rates in investor-owned, nonprofit, and public nursing homes. A multivariate model was used to control for case mix, percentage of residents covered by Medicaid, whether the facility was hospital-based, whether it was a skilled nursing facility for Medicare only, chain ownership, and location by state. The study also assessed nurse staffing. The authors found that investor-owned nursing homes provide worse care and less nursing care than nonprofit or public homes. Investor-owned facilities averaged 5.89 deficiencies per home, 46.5 percent higher than nonprofit and 43.0 percent higher than public facilities, and also had more of each category of deficiency. In the multivariate analysis, investor-ownership predicted 0.679 additional deficiencies per home; chain-ownership predicted an additional 0.633 deficiencies per home. Nurse staffing ratios were markedly lower at investor-owned homes.


2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S160-S160 ◽  
Author(s):  
Tamanna Hossin ◽  
Mozhdeh Bahranian ◽  
Lyndsay Taylor ◽  
David Nace ◽  
Christopher Crnich

2018 ◽  
Vol 27 (01) ◽  
pp. 156-162 ◽  
Author(s):  
Harshana Liyanage ◽  
Siaw-Teng Liaw ◽  
Emmanouela Konstantara ◽  
Freda Mold ◽  
Richard Schreiber ◽  
...  

Background: Patients' access to their computerised medical records (CMRs) is a legal right in many countries. However, little is reported about the benefit-risk associated with patients' online access to their CMRs. Objective: To conduct a consensus exercise to assess the impact of patients' online access to their CMRs on the quality of care as defined in six domains by the Institute of Medicine (IoM), now the National Academy of Medicine (NAM). Method: A five-round Delphi study was conducted. Round One explored experts' (n = 37) viewpoints on providing patients with access to their CMRs. Round Two rated the appropriateness of statements arising from Round One (n = 16). The third round was an online panel discussion of findings (n = 13) with the members of both the International Medical Informatics Association and the European Federation of Medical Informatics Primary Health Care Informatics Working Groups. Two additional rounds, a survey of the revised consensus statements and an online workshop, were carried out to further refine consensus statements. Results: Thirty-seven responses from Round One were used as a basis to initially develop 15 statements which were categorised using IoM's domains of care quality. The experts agreed that providing patients online access to their CMRs for bookings, results, and prescriptions increased efficiency and improved the quality of medical records. Experts also anticipated that patients would proactively use their online access to share data with different health care providers, including emergencies. However, experts differed on whether access to limited or summary data was more useful to patients than accessing their complete records. They thought online access would change recording practice, but they were unclear about the benefit-risk of high and onerous levels of security. The 5-round process, finally, produced 16 consensus statements. Conclusion: Patients' online access to their CMRs should be part of all CMR systems. It improves the process of health care, but further evidence is required about outcomes. Online access improves efficiency of bookings and other services. However, there is scope to improve many of the processes of care it purports to support, particularly the provision of a more effective interface and the protection of the vulnerable.


2020 ◽  
Vol 10 (1) ◽  
pp. 11-24
Author(s):  
Agustinus Hermino

Latar belakang: Seiring dengan perkembangan jaman, dalam beberapa tahun terakhir ini banyak perhatian yang difokuskan pada eksplorasi dampak penyakit fisik dan mental pada kualitas hidup seseorang baik secara individu maupun masyarakat secara keseluruhan. Sifat subyektif dari 'kualitas hidup' individu, merupakan konsep yang dinamis untuk diukur dan didefinisikan, tetapi bahwa secara umum dapat dipandang sebagai konsep multidimensi yang menekankan pada persepsi diri dari keadaan pikiran seseorang saat iniTujuan: penulisan ini bertujuan untuk memberikan pemahaman tentang peran masyarakat dalam memahani pentingnya kesehatan di era global ditinjau dari perspektif akademis. Pada sektor kesehatan pemahaman kesehatan menjadi sangat pentingnya karena akan menunjukkan pada kualitas hidup seseorang, tetapi hal ini tidak cukup secara individu karena diperlukan pemahaman secara menyeluruh terhadap masyarakat tentang makna kesehatan dan perawatan kesehatan.Metode: penulisan ilmiah ini adalah dengan melakukan analisa akademis dari dari berbagai sumber rujukan relevan sehingga menemukan makna teoritis baru dalam rangka menjawab tantangan yang terjadi di masyarakat.Hasil: Berdasarkan berbagai sumber rujukan yang ada, dapat disimpulkan bahwa kesehatan merupakan gaya hidup yang bertujuan untuk mencapai kesejahteraan fisik, emosional, intelektual, spiritual, dan lingkungan. Penggunaan langkah-langkah kesehatan dapat meningkatkan stamina, energi, dan harga diri, kemudian meningkatkan kualitas hidup. Dengan demikian maka konsep kesehatan memungkinkan adanya variabilitas individu. Kesehatan dapat dianggap sebagai keseimbangan aspek fisik, emosional, psikologis, sosial dan spiritual dari kehidupan seseorang. Kata kunci: masyarakat, perawatan kesehatan, kualitas hidup Society Community and Health Care in Improving Quality of LifeAbstract Background: Along with the development of the era, in recent years there has been a lot of attention focused on exploring the impact of physical and mental illness on the quality of life of a person both individually and as a whole. The subjective nature of an individual's 'quality of life' is a dynamic concept to measure and define, but that in general can be seen as a multidimensional concept that emphasizes self-perception of one's current state of mindAim: purpose of this study is to provide an understanding the role of community in understanding the importance of health in the global era from an academic perspective. In the health sector understanding of health is very important because it will show the quality of life of a person, but this is not enough individually because a comprehensive understanding of the meaning of health and health care is needed. Method: The method of scientific writing is to carry out academic analysis from various relevant reference sources, and find new theoretical meanings in order to answer the challenges that occur in society. Keyword: Community, Society,Health Care, Quality oflife Resullt : Based on various academic reference, it can be concluded that health is a lifestyle that aims to achieve physical, emotional, intellectual, spiritual, and environmental well-being. The use of health measures can increase stamina, energy, and self-esteem, then improve the quality of life. Thus the concept of health allows for individual variability. Health can be considered as a balance of physical, emotional, psychological, social and spiritual aspects of one's life. Keywords: community, health care, quality of life 


Author(s):  
Diadjeng Setya W ◽  
◽  
Miftahul Jannah ◽  
Rismaina Putri ◽  
◽  
...  

ABSTRACT Background: Fulfilment of nutrition in the first 1000 days of life greatly affects the development of a child’s brain and body. If the nutritional intake is not fulfilled, the impact on children’s development will be permanent, one of which is stunting. This study aimed to compare the quality of antenatal care (ANC) by midwives in the stunting locus and not the stunting locus village. Subjects and Method: This was a comparative analytic with cross-sectional study conducted in stunting locus and not stunting locus village in Malang Regency from August-December 2019. A total of 84 midwives were enrolled in this study by purposive sampling. The data were collected by questionnaire. Data were analyzed using a multiple linear regression. Results: Quality of ANC in stunting locus and not stunting locus village were not showing good results. The most dominant influence on the quality of ANC midwives in the stunting locus was the length of work of the midwives. Meanwhile, the most dominant influence on the quality of ANC midwives in non-stunting locus was the latest education. Conclusion: Quality of ANC in stunting locus and not stunting locus village are not yet showing good results. Keywords: stunting, quality, antenatal care, midwives Correspondence: Diadjeng Setya Wardani. Faculty of Medicine, Universitas Brawijaya. Jl. Veteran Malang, East Java, Indonesia. [email protected] DOI: https://doi.org/10.26911/the7thicph.03.06


2021 ◽  
Vol 4 (2) ◽  
pp. 24
Author(s):  
Kateřina Glumbíková

Social work in the Czech Republic is confronted with the impact of global neoliberalism, which is manifested by privatisation of social services, individualisation of social risks and economisation. Reflexivity of social workers working with vulnerable children and their families has the potential to lead to a higher quality of social work, strengthening of social workers' identity, and empowering social workers to promote changes in everyday practice. Meeting this potential requires an understanding of constructing reflexivity by social workers, which is the objective of this paper. We used a qualitative research strategy, particularly group and individual interviews with social workers and their analysis using current approaches to grounded theory. Concerning data analysis, we found out that constructing reflexivity (nature and subject of reflexion) derives from the perceived roles of social workers (social worker as an ununderstood artist, social worker a as mediator between social and individual, social workers as an agent of a (society) change, social workers as an agent of normalisation and reflexive professional). The acquired data, within the situational analysis, was inserted into a position map on the scale of holistic and technical reflection. The conclusion discusses the implication for practice and education in social work.


2016 ◽  
Vol 75 (1) ◽  
Author(s):  
Godwin O. Ovenseri-Ogbomo ◽  
Harriette Osafo-Agyei ◽  
Ralph E.U. Akpalaba ◽  
James Addy ◽  
Elizabeth O. Ovenseri

Patients’ perspectives on the impact of clinical interventions have been recognised as critical elements in patient care. Quality-of-life instruments are designed to measure these perspectives. We used the National Eye Institute’s 25-item Visual Function Questionnaire (NEI VFQ) to measure the impact of optical low vision devices on the quality of life of 22 low vision patients who obtained and were using low vision devices from a secondary low vision clinic in the Eastern Region, Ghana. The study employed a pre- and post-intervention technique. We found statistically significant improvements in measured visual acuity and NEI VFQ scores in 8 of the 10 domains evaluated. We conclude that optical low vision devices have a positive impact on the quality of life of low vision patients in Ghana.Keywords: low vision; quality of life; visual acuity; visual impairment; Ghana


2018 ◽  
Vol 74 (5) ◽  
pp. 689-697 ◽  
Author(s):  
Maricruz Rivera-Hernandez ◽  
Momotazur Rahman ◽  
Dana B Mukamel ◽  
Vincent Mor ◽  
Amal N Trivedi

Sign in / Sign up

Export Citation Format

Share Document