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Can J Aging. 2014 Mar;33(1):38-48. doi: 10.1017/S0714980813000615. Epub 2014 Jan 3.

Nursing home characteristics associated with resident transfers to emergency departments.

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Department of Family Practice, University of British Columbia.
Vancouver Coastal Health Research Institute Centre for Clinical Epidemiology & Evaluation.
Centre for Health Services and Policy Research, University of British Columbia.
Emergency and Health Services Commission.
School of Nursing, University of British Columbia.
Department of Statistics, University of British Columbia.


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.

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