XXXX and resource use of nursing home residents: a structural equation model.

@entity1 @entity146 @entity303 @entity73 @entity1109 @entity195
BACKGROUND: Only a few studies have examined relationships between @entity73 and resource use of nursing home residents, and these studies have yielded mixed results. METHODS: To develop and test structural equation models for relationships between @entity73 , covariates, and resource use of nursing home residents on @entity195 @entity1109 ( @entity1109 ) and conventional units. RESEARCH DESIGN: Analysis of data obtained in 1999 from an Indiana nursing facility time study that measured resident-specific direct care minutes per day, and assessment data from the Minimum Data Set (version 2.0). @entity1 : @entity1 were 1290 residents without specialized nursing requirements or licensed therapies: 447 drawn from 22 @entity1109 in 16 facilities, 485 from 16 conventional units in the same facilities, and 358 from units in 13 facilities without @entity1109 . MEASURES: Direct care resource use (weighed minutes/d), Cognitive Performance Scale, activities of daily living (ADLs), clinically complex conditions, daily @entity146 , physical restraints, psychotropic medication, and @entity195 or @entity303 diagnosis. RESULTS: @entity73 had a substantial indirect effect on resource use in facilities with and without @entity1109 . This effect was mediated largely through ADL dependency and SCU placement. Severity of @entity73 was strongly related to ADL dependency, and ADL, in turn, was a strongly related to resource use. Also, residents on @entity1109 used significantly more direct care resources than residents on conventional units. CONCLUSIONS: This study demonstrates relationships between @entity73 , covariates, and resource use for nursing home residents on @entity1109 and conventional units. It also raises issues about reimbursement for care of @entity303 residents.
