title: Nursing home characteristics associated with resident transfers to emergency departments.
abstract: This study examined how nursing home facility ownership and organizational characteristics relate to emergency department (ED) transfer rates. The sample included a retrospective cohort of nursing home residents in the Vancouver Coastal Health region (n = 13,140). Rates of ED transfers were compared between nursing home ownership types. Administrative data were further linked to survey-derived data of facility organizational characteristics for exploratory analysis. Crude ED transfer rates (transfers/100 resident years) were 69, 70, and 51, respectively, in for-profit, non-profit, and publicly owned facilities. Controlling for sex and age, public ownership was associated with lower ED transfer rates compared to for-profit and non-profit ownership. Results showed that higher total direct-care nursing hours per resident day, and presence of allied health staff--disproportionately present in publicly owned facilities--were associated with lower transfer rates. A number of other facility organizational characteristics--unrelated to ownership--were also associated with transfer rates.
authors.affiliation: Department of Family Practice, University of British Columbia.
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: McGregor
authors.affiliation: Vancouver Coastal Health Research Institute Centre for Clinical Epidemiology & Evaluation.
authors.forename: Riyad B
authors.initials: RB
authors.lastname: Abu-Laban
authors.affiliation: Department of Family Practice, University of British Columbia.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Ronald
authors.affiliation: Centre for Health Services and Policy Research, University of British Columbia.
authors.forename: Kimberlyn M
authors.initials: KM
authors.lastname: McGrail
authors.affiliation: Emergency and Health Services Commission.
authors.forename: Douglas
authors.initials: D
authors.lastname: Andrusiek
authors.affiliation: School of Nursing, University of British Columbia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Baumbusch
authors.affiliation: Vancouver Coastal Health Research Institute Centre for Clinical Epidemiology & Evaluation.
authors.forename: Michelle B
authors.initials: MB
authors.lastname: Cox
authors.affiliation: Vancouver Coastal Health Research Institute Centre for Clinical Epidemiology & Evaluation.
authors.forename: Kia
authors.initials: K
authors.lastname: Salomons
authors.affiliation: Department of Statistics, University of British Columbia.
authors.forename: Michael
authors.initials: M
authors.lastname: Schulzer
authors.affiliation: Vancouver Coastal Health Research Institute Centre for Clinical Epidemiology & Evaluation.
authors.forename: Lisa
authors.initials: L
authors.lastname: Kuramoto
mesh_terms: D000369:Aged, 80 and over; D000375:Aging; D001955:British Columbia; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000458:organization & administration*; D010067:Ownership / Q000458:organization & administration; D010360:Patient Transfer / Q000706:statistics & numerical data; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data; D011787:Quality of Health Care; D012189:Retrospective Studies; D000078329:Workforce