title: The association between quality of care and quality of life in long-stay nursing home residents with preserved cognition.
abstract: OBJECTIVE
  To assess the overall quality of life of long-stay nursing home residents with preserved cognition, to examine whether the Centers for Medicare and Medicaid Service's Nursing Home Compare 5-star quality rating system reflects the overall quality of life of such residents, and to examine whether residents' demographics and clinical characteristics affect their quality of life.
  
  
  METHODS
  Quality of life was measured using the Participant Outcomes and Status Measures-Nursing Facility survey, which has 10 sections and 63 items. Total scores range from 20 (lowest possible quality of life) to 100 (highest).
  
  
  METHODS
  Long-stay nursing home residents with preserved cognition (n = 316) were interviewed.
  
  
  RESULTS
  The average quality- of-life score was 71.4 (SD: 7.6; range: 45.1-93.0). Multilevel regression models revealed that quality of life was associated with physical impairment (parameter estimate = -0.728; P = .04) and depression (parameter estimate = -3.015; P = .01) but not Nursing Home Compare's overall star rating (parameter estimate = 0.683; P = .12) and not pain (parameter estimate = -0.705; P = .47).
  
  
  CONCLUSIONS
  The 5-star quality rating system did not reflect the quality of life of long-stay nursing home residents with preserved cognition. Notably, pain was not associated with quality of life, but physical impairment and depression were.
authors.affiliation: Department of Public Health, Yonsei University College of Medicine, Seoul, Korea; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sun Jung
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Eun-Cheol
authors.initials: EC
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, University of Washington School of Medicine, Seattle, WA.
authors.forename: Sulgi
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Nakagawa
authors.affiliation: Center for Senior Health and Longevity, Aurora Health Care, Milwaukee, WI.
authors.forename: John
authors.initials: J
authors.lastname: Lung
authors.affiliation: Department of Pain Medicine and Anesthesia, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jong Bum
authors.initials: JB
authors.lastname: Choi
authors.affiliation: Center for Clinical Research, Korea University College of Medicine, Seoul, Korea.
authors.forename: Woo Sang
authors.initials: WS
authors.lastname: Ryu
authors.affiliation: Department of Pain Medicine and Anesthesia, Korea University College of Medicine, Seoul, Korea.
authors.forename: Too Jae
authors.initials: TJ
authors.lastname: Min
authors.affiliation: Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Hyun Phil
authors.initials: HP
authors.lastname: Shin
authors.affiliation: Korean Advanced Institute of Science and Technology, Daejeon, Korea.
authors.forename: Kyudam
authors.initials: K
authors.lastname: Kim
authors.affiliation: Center for Senior Health and Longevity, Aurora Health Care, Milwaukee, WI; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Milwaukee, WI. Electronic address: ji.yoo@aurora.org.
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Yoo
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D014487:Centers for Medicare and Medicaid Services, U.S.; D003071:Cognition; D006801:Humans; D008134:Long-Term Care; D008824:Michigan; D008875:Middle Aged; D009735:Nursing Homes; D036301:Qualitative Research; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014481:United States; D019037:Urban Health Services
keywords: Activity of daily living; cognition; nursing home; quality of health care; quality of life