A comparison of differences in the outcome (hospitalization and mortality) between two special nursing homes of the same size managed by the same organization

Abstract

The purpose of this study was to examine the usefulness of information about outcome in evaluation of the quality of special nursing homes. Two special nursing homes A and B were selected. These two facilities were the same in their service capacity and are also owned as well as managed by the same organization. There were no differences in the structural elements between the two facilities. The hospitalization and mortality rate of the two facilities were compared. There were no significant differences in terms of the distribution of the characteristics of the residents between facility A and B at the time of their admission. However, the average survival time of the persons who died was significantly shorter in facility B than that in facility A. (A facility = 1,165 days, B facility = 831 days; p < 0.05). There were significant differences in cumulative survival and non-hospitalization rate of residents in the two facilities (p < 0.05). The differences were seen even after controlling for the prognostic factors by Cox's proportional hazard model (hazard rate: mortality = 1.562, hospitalization = 2.526, p < 0.01). Furthermore, the proportion of residents hospitalized right after their first visit to the hospital was significantly higher in facility B than that in facility A (A = 9.6%, B = 19.3%; p < 0.05). Also, the mortality risk of hospitalized persons was significantly higher than non-hospitalized persons in facility B (p < 0.05), although there was no significant difference in terms of the mortality risk between the two groups in facility A. Because the differences in the cumulative survival and non-hospitalization rate could occur in the facilities that are similar in institutional structures, it suggests that these outcomes are indicators of the quality of special nursing homes. It would be, therefore, important to collect the information about outcome including cumulative survival and non-hospitalization rate of the residents in order to evaluate the quality of special nursing homes.