Pressure ulcer prevalence in long-term nursing home residents since the implementation of OBRA '87. Omnibus Budget Reconciliation Act.
OBJECTIVE
To evaluate change in pressure ulcer prevalence in long-term nursing home residents since the implementation of the Omnibus Budget Reconciliation Act of 1987 (OBRA '87).


METHODS
Cross-sectional comparison of two time periods.


METHODS
Ninety-two nursing homes scheduled for a quality-of-care survey randomly selected from 22 representative states.


METHODS
Four thousand six hundred seventy-nine residents who had resided in the facility for at least 100 days were evaluated: 2,336 during 1992-1994 and 2,343 during 1997-1998.


METHODS
Trained registered nurses collected data on pressure ulcer prevalence, stage, and risk factors from medical record review during on-site evaluations. Risk-adjusted differences were estimated using logistic regression.


RESULTS
Unadjusted prevalence rates for all stages of pressure ulcers (8.52% vs 8.54%, P =.983) and those rated stage 2 or greater (5.31% vs 5.63%, P =.624) did not differ between the two time periods. After adjustment for urinary incontinence, immobility, poor nutrition, and history of previous pressure ulcers, the relative odds of having a pressure ulcer in 1992/4 versus 1997/8 was 1.06 (95% confidence interval (CI) = 0.84-1.34) for all stages and 1.21 (95% CI = 0.92-1.60) for stages 2 and greater.


CONCLUSIONS
No change in pressure ulcer prevalence was demonstrated since implementation of OBRA '87 in this nationally derived sample of long-term nursing home residents.
Coleman
Eric A
EA
Center on Aging Research Section, Division of Geriatrics, University of Colorado Health Sciences Center, Denver, Colorado 80206, USA. Eric.Coleman@uchsc.edu
Martau
James M
JM
Lin
Michael K
MK
Kramer
Andrew M
AM
D014487:Centers for Medicare and Medicaid Services, U.S.; D003430:Cross-Sectional Studies; D006801:Humans; D007902:Length of Stay; D009735:Nursing Homes; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011787:Quality of Health Care; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology