PDF(Pubmed)
Abstract：
OBJECTIVE: A better understanding of factors associated with assisted living admission and discharge practices can help identify communities that are more likely to allow residents to age in place. This study examined how state regulations and assisted living organizational characteristics related to community admission and discharge practices for bathing, getting out of bed, and feeding.
METHODS: Using data from a representative sample of 250 assisted living communities in seven states and a database of assisted living state regulations, we employed multilevel logistic regression models to examine regulatory and organizational correlates of assisted living community admission and discharge practices for 3 activities of daily living (bathing, getting out of bed, and feeding).
RESULTS: States\' regulations were not associated with assisted living community admission and discharge practices. However, assisted living communities above the median in the number of personal care staff members per resident were 17% (95% confidence interval [CI]: 6.5%, 27.1%) more likely to admit residents who needed assistance with feeding and 25.4% (95% CI: -37.7, -13.2) less likely to discharge these residents. For-profit communities were more likely to admit residents with bathing and feeding limitations.
CONCLUSIONS: Organizational characteristics (e.g., for-profit affiliation, staffing levels) may, in part, drive admission and discharge practices, especially related to different care needs. The ability to house residents with advanced care needs may be influenced more by the organizational resources available to care for these residents than by states\' admission and discharge regulations.
METHODS: Using data from a representative sample of 250 assisted living communities in seven states and a database of assisted living state regulations, we employed multilevel logistic regression models to examine regulatory and organizational correlates of assisted living community admission and discharge practices for 3 activities of daily living (bathing, getting out of bed, and feeding).
RESULTS: States\' regulations were not associated with assisted living community admission and discharge practices. However, assisted living communities above the median in the number of personal care staff members per resident were 17% (95% confidence interval [CI]: 6.5%, 27.1%) more likely to admit residents who needed assistance with feeding and 25.4% (95% CI: -37.7, -13.2) less likely to discharge these residents. For-profit communities were more likely to admit residents with bathing and feeding limitations.
CONCLUSIONS: Organizational characteristics (e.g., for-profit affiliation, staffing levels) may, in part, drive admission and discharge practices, especially related to different care needs. The ability to house residents with advanced care needs may be influenced more by the organizational resources available to care for these residents than by states\' admission and discharge regulations.
摘要：
目的：更好地了解与辅助生活入院和出院实践相关的因素，可以帮助确定更有可能允许居民年龄的社区。这项研究研究了州法规和辅助生活组织特征与社区入室和出院习惯之间的关系。起床,和喂养。
方法：使用来自7个州250个辅助生活社区的代表性样本和辅助生活州法规数据库的数据，我们采用多水平逻辑回归模型来检查辅助生活社区入院和出院实践的监管和组织相关性，以进行三种日常生活活动（ADL[沐浴，起床,andfeeding]).
结果：各州的规定与辅助生活社区入院和出院实践无关。然而,高于每位居民个人护理人员人数中位数的辅助生活社区为17%(95%CI：6.5%，27.1％）更有可能接纳需要喂养援助的居民，而25.5％（95％CI：-37.7，-13.2）不太可能解雇这些居民。营利性社区更有可能接纳有沐浴和喂养限制的居民。
结论：组织特征(例如，营利性隶属关系，人员配备水平)可能会部分推动入学和出院做法，特别是与不同的护理需求有关。容纳有高级护理需求的居民的能力可能更多地受到可用于护理这些居民的组织资源的影响，而不是各州的入院和出院规定。
方法：使用来自7个州250个辅助生活社区的代表性样本和辅助生活州法规数据库的数据，我们采用多水平逻辑回归模型来检查辅助生活社区入院和出院实践的监管和组织相关性，以进行三种日常生活活动（ADL[沐浴，起床,andfeeding]).
结果：各州的规定与辅助生活社区入院和出院实践无关。然而,高于每位居民个人护理人员人数中位数的辅助生活社区为17%(95%CI：6.5%，27.1％）更有可能接纳需要喂养援助的居民，而25.5％（95％CI：-37.7，-13.2）不太可能解雇这些居民。营利性社区更有可能接纳有沐浴和喂养限制的居民。
结论：组织特征(例如，营利性隶属关系，人员配备水平)可能会部分推动入学和出院做法，特别是与不同的护理需求有关。容纳有高级护理需求的居民的能力可能更多地受到可用于护理这些居民的组织资源的影响，而不是各州的入院和出院规定。
