Does the presence of a dementia special care unit improve nursing home quality?
OBJECTIVE
This study quantifies the effect of a new dementia special care unit (D-SCU) on the provision of care to all residents in a nursing home (NH).


METHODS
The authors use data from the On-line Survey Certification and Reporting system to identify free-standing NHs that first reported a D-SCU between 1996 and 2003 (N = 1,519). Fixed-effects models estimate the effect of a new D-SCU on the prevalence of each outcome (physical restraints, feeding tubes, and psychotropic medications) while controlling for secular trends.


RESULTS
For all NHs, the use of physical restraints declined, the use of antipsychotics increased, and other measures remained relatively constant. The introduction of a D-SCU was not associated with changes in trends for any measure.


CONCLUSIONS
Differences in care processes between NHs with and without D-SCUs are the result of differences in their underlying approach to care, not the result of care practice diffusion from the D-SCU.
Gruneir
Andrea
A
Kunin-Lunenfeld Applied Research Unit, Baycrest, USA.
Lapane
Kate L
KL
Miller
Susan C
SC
Mor
Vincent
V
D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003695:Delivery of Health Care / Q000639:trends*; D003704:Dementia / Q000628:therapy*; D004750:Enteral Nutrition / Q000706:statistics & numerical data; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D009735:Nursing Homes / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care / Q000639:trends; D011787:Quality of Health Care / Q000639:trends*; D012149:Restraint, Physical / Q000706:statistics & numerical data; D013041:Specialties, Nursing / Q000458:organization & administration*; D014481:United States
D014151:Anti-Anxiety Agents; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives