Organizational relationships between nursing homes and hospitals and quality of care during hospital-nursing home patient transfers.
OBJECTIVE
To identify organizational factors and hospital and nursing home organizational relationships associated with more-effective processes of care during hospital-nursing home patient transfer.


METHODS
Mailed survey.


METHODS
Medicare- or Medicaid-certified nursing homes in New York State.


METHODS
Nursing home administrators, with input from other nursing home staff.


METHODS
Key predictor variables were travel time between the hospital and the nursing home, affiliation with the same health system, same corporate owner, trainees from the same institution, pharmacy or laboratory agreements, continuous physician care, number of beds in the hospital, teaching status, and frequency of geriatrics specialty care in the hospital. Key dependent variables were hospital-to-nursing home communication, continuous adherence to healthcare goals, and patient and family satisfaction with hospital care.


RESULTS
Of 647 questionnaires sent, 229 were returned (35.4%). There was no relationship between hospital-nursing home interorganizational relationships and communication, healthcare goal adherence, and satisfaction measures. Geriatrics specialty care in the hospital (r=0.157; P=.04) and fewer hospital beds (r=-0.194; P=.01) were each associated with nursing homes more often receiving all information needed to care for patients transferred from the hospital. Teaching status (r=0.230; P=.001) and geriatrics specialty care (r=0.185; P=.01) were associated with hospital care more often consistent with healthcare goals established in the nursing home.


CONCLUSIONS
No management-level organizational relationship between nursing home and hospital was associated with better hospital-to-nursing home transfer process of care. Geriatrics specialty care and characteristics of the hospital were associated with better hospital-to-nursing home transfer processes.
Boockvar
Kenneth S
KS
Geriatrics Research, Education, and Clinical Center, J.J. Peters Veterans Affairs Medical Center, Bronx, New York 10468, USA. kenneth.boockvar@mssm.edu
Burack
Orah R
OR
D019983:Guideline Adherence; D006739:Hospital Administration / Q000592:standards*; D006801:Humans; D009518:New York; D009735:Nursing Homes / Q000458:organization & administration*; D010360:Patient Transfer / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000639:trends*; D011795:Surveys and Questionnaires; D014164:Transfer Agreement / Q000592:standards*