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    Quality of Nursing Homes Admitting Working-Age Adults With Serious Mental Illness

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    Authors
    Hugunin, Julie
    Chen, Qiaoxi
    Baek, Jonggyu
    Clark, Robin E.
    Lapane, Kate L.
    Ulbricht, Christine M.
    UMass Chan Affiliations
    Department of Population and Quantitative Health Sciences
    Clinical and Population Health Research Program, Morningside Graduate School of Biomedical Sciences
    Document Type
    Journal Article
    Publication Date
    2021-12-16
    Keywords
    Nursing homes
    Quality of care
    Schizoaffective disorders
    Schizophrenia
    Serious mental illness
    Epidemiology
    Health Services Administration
    Health Services Research
    Psychiatry and Psychology
    UMCCTS funding
    
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    Link to Full Text
    https://doi.org/10.1176/appi.ps.202100356
    Abstract
    OBJECTIVE: This cross-sectional study examined the association between nursing home quality and admission of working-age persons (ages 22-64 years) with serious mental illness. METHODS: The study used 2015 national Minimum Data Set 3.0 and Nursing Home Compare (NHC) data. A logistic mixed-effects model estimated the likelihood (adjusted odds ratios [AORs] and 95% confidence intervals [CIs]) of a working-age nursing home resident having serious mental illness, by NHC health inspection quality rating. The variance partition coefficient (VPC) was calculated to quantify the variation in serious mental illness attributable to nursing home characteristics. Measures included serious mental illness (i.e., schizophrenia, bipolar disorder, and other psychotic disorders), health inspection quality rating (ranging from one star, below average, to five stars, above average), and other sociodemographic and clinical covariates. RESULTS: Of the 343,783 working-age adults newly admitted to a nursing home in 2015 (N=14,307 facilities), 15.5% had active serious mental illness. The odds of a working-age resident having serious mental illness was lowest among nursing homes of above-average quality, compared with nursing homes of below-average quality (five-star vs. one-star facility, AOR=0.78, 95% CI=0.73-0.84). The calculated VPC from the full model was 0.11. CONCLUSIONS: These findings indicate an association between below-average nursing homes and admission of working-age persons with serious mental illness, suggesting that persons with serious mental illness may experience inequitable access to nursing homes of above-average quality. Access to alternatives to care, integration of mental health services in the community, and improving mental health care in nursing homes may help address this disparity.
    Source

    Hugunin J, Chen Q, Baek J, Clark RE, Lapane KL, Ulbricht CM. Quality of Nursing Homes Admitting Working-Age Adults With Serious Mental Illness. Psychiatr Serv. 2021 Dec 16:appips202100356. doi: 10.1176/appi.ps.202100356. Epub ahead of print. PMID: 34911354. Link to article on publisher's site

    DOI
    10.1176/appi.ps.202100356
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47897
    PubMed ID
    34911354
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1176/appi.ps.202100356
    Scopus Count
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    Morningside GSBS Scholarly Publications
    Population and Quantitative Health Sciences Publications
    UMass Center for Clinical and Translational Science Supported Publications

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