scholarly journals The Impact of Marketization on the Quality of Care in Long-term Care Program

2014 ◽  
Vol 41 (1) ◽  
pp. 289-313 ◽  
Author(s):  
권현정
2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht

Abstract Nursing home facilities are responsible for providing care for some of the most vulnerable groups in society, including the elderly and those with chronic medical conditions. In times of crisis, such as COVID-19 or other pandemics, the delivery of ‘regular’ care can be significantly impacted. In relation to COVID-19, there is an insufficient supply of personal protective equipment (PPE) to care for residents, as PPE not only protects care staff but also residents. Nursing homes across the United States and Canada have also taken protective measures to maximize the safety of residents by banning visitors, stopping all group activities, and increasing infection control measures. This presentation shares a research protocol and early findings from a study investigating the impact of COVID-19 on quality of care in residential long-term care (LTC) in the Canadian province of New Brunswick. This study used a qualitative description design to explore what contributes to quality of care for residents living in long-term care, and how this could change in times of crisis from the perspective of long-term care staff. Interviews were conducted with a broad range of staff at one LTC home. A semi-structured interview guide and approach to thematic analysis was framed by a social ecological perspective, making it possible to include the individual and proximal social influences as well as community, organizations, and policy influencers. Insights gained will improve the understanding of quality of care, as well as potential barriers and facilitators to care during times of crisis.


Author(s):  
Feliciano Villar ◽  
Rodrigo Serrat ◽  
Annette Bilfeldt ◽  
Joe Larragy

AbstractLiving in a long-term care (LTC) institution provides older people experiencing health and social problems with a comprehensive range of support services that address their quality of life. Despite access to such services, challenges arise in relation to their participation in key activities both within and outside the institution. This chapter examines such challenges, reviewing and describing ways to prevent exclusion along various domains, specifically social relationships, civic participation and socio-cultural life. Firstly, we discuss ways in which bio-medical models of care and the quality control systems, which are dominant in LTC services, standardise care, tending to put decisions exclusively in hands of staff, taking away residents’ autonomy, and ultimately curtailing rights and citizenship status. Secondly, we examine how LTC services might prevent such exclusion and promote older people’s participation in at least four respects: (1) prompting and supporting residents’ ability to take decisions on their own care, (2) favouring the maintenance and creation of social relationships, (3) enabling residents’ participation in the activities and management of the institution, and (4) guaranteeing residents’ rights and full access to citizenship. We discuss the impact and limitations of recent initiatives put into practice in these areas of practice.


2008 ◽  
Vol 35 (1) ◽  
pp. 49 ◽  
Author(s):  
R. Colin Reid

Seniors with dementia who enter long-term care facilities are at greater risk of death than are similar individuals that remain in the community. Previous research has focused primarily on social selection factors such as health status to explain mortality in this population. This study seeks to determine whether resident mortality within 12 months of admission to a facility can be explained by post-admission social causative factors, that is, by institutional quality of care. Logistic regression results are based on the study of 402 residents in 73 long-term care facilities throughout British Columbia, Canada. Mortality data were obtained from Vital Statistics. Although social selection factors (e.g., physical dependency) emerge as the strongest predictors, one social causative factor – facility level restraint use – also predicts mortality. This study provides some evidence that social causative factors play a role in determining mortality among long-term care residents with dementia. Further research on the social causative factors is needed to understand the degree to which they affect mortality, and the way in which they do so.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jillian L. Shotwell ◽  
Eve Wool ◽  
Andrzej Kozikowski ◽  
Renee Pekmezaris ◽  
Jill Slaboda ◽  
...  

Abstract Background Home-bound patients in New York State requiring long-term care services have seen significant changes to their benefits due to turmoil in the Managed Long Term Care (MLTC) market. While there has been research conducted regarding the effect of MLTC challenges on beneficiaries, the impact of MLTC regulatory changes on home health aides has not been explored. Methods Qualitative interviews were conducted with formal caregivers, defined as paid home health aides (HHAs) (n = 13) caring for patients in a home-based primary care program in the New York City metropolitan area. HHAs were asked about their satisfaction with the home based primary care program, their own job satisfaction, and whether HHA restrictions affect their work in any way. Interviews were audio-recorded, transcribed, and analyzed. Results Two main themes emerged: (1) Pay, benefits and hours worked and (2) Concerns about patient well-being afterhours. HHAs are working more hours than they are compensated for, experience wage stagnation and loss of benefits, and experience stress related to leaving frail clients alone after their shifts end. Conclusions HHAs experience significant job-related stress when caring for frail elderly patients at home, which may have implications for both patient care and HHA turnover. As government bodies contemplate new policy directions for long-term care programs which rely on HHAs the impact of these changes on this vulnerable workforce must be considered.


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