The effects of special nursing units in nursing homes on healthcare utilization and cost: A case-control study using propensity score matching.

BACKGROUND: Most nursing homes in South Korea lack professional nursing services, resulting in transporting residents to hospitals for mild health problems and nursing treatment needs. While the number of nursing homes has increased, the number of registered nurses working in nursing homes has declined. In 2019, the Korean Ministry of Health and Welfare and the National Health Insurance Service launched the Special Nursing Units in Nursing Homes, a pilot nurse-led model, to resolve the lack of health and nursing services in nursing homes by mandating registered nurses' minimum staffing levels and protecting their scope of practice. OBJECTIVE: This study explored the effects of the Special Nursing Units model in Nursing Homes on healthcare utilization and cost among nursing home residents. DESIGN: A comparative effectiveness research design using propensity score matching. SETTING(S): Eighteen nursing homes were selected based on the region and number of beds. PARTICIPANTS: There were 323 matched-pairs of residents from the case and control groups. METHODS: Nursing homes with more than 30 beds were recruited nationwide, with 18 nursing homes being selected based on the region and number of beds. The case group included 323 older adults receiving professional nursing services by registered nurses under the Special Nursing Units model in Nursing Homes for more than six months consecutively in 18 nursing homes between April and December 2019. We matched control participants using propensity score matching with health insurance and long-term care data. We analyzed the differences in healthcare utilization and cost changes between the case and control groups using generalized estimating equations. RESULTS: The groups were not statistically different in baseline demographic or health-related characteristics. There were 26 (8.1%) and 30 (9.3%) deaths in the case and control groups, respectively, during the six months of the model, which was not statistically different (p = .576). The case group showed statistically significant decreases in healthcare utilization and costs, including hospitalization frequency (p = .008), length of stay (p = .002), and hospitalization costs (p = .003); outpatient visit frequency (p = .003) and costs (p < .001); and home healthcare frequency (p < .001) and cost (p < .001) than the control group. CONCLUSIONS: Professional nursing services by registered nurses under the Special Nursing Units model in Nursing Homes decreased healthcare utilization and costs. A nurse-led model in nursing homes, which includes mandating the minimum staffing levels of registered nurses and protecting their scope of practice, promises to improve resident health outcomes.

Research Note: Simultaneous detection of infectious laryngotracheitis virus, fowlpox virus, and reticuloendotheliosis virus in chicken specimens.

Infectious laryngotracheitis (ILT), fowlpox (FP), and reticuloendotheliosis are important poultry diseases caused by gallid herpesvirus 1 (ILTV), fowlpox virus (FWPV), and reticuloendotheliosis virus (REV), respectively. Coinfections with ILTV and FWPV occur naturally in chickens, and FP in its more virulent wet form is characterized by diphtheritic lesions and easily confused with ILT. Moreover, the insertion of only partial REV-LTR or a nearly full-length REV into the FWPV genome, located between the ORF 201 and ORF 203, has increased recently in wild-type field FWPV isolates. Therefore, it is critical to detect ILTV, FWPV, REV-integrated FWPV, and REV early and accurately. In this study, we successfully developed a multiplex PCR assay for the simultaneous detection of ILTV, FWPV, REV-integrated FWPV, and REV, and the detection limits was 1 × 54 copies/tube. When used to test clinical samples, the results of the multiplex PCR were in 100% agreement with singleplex PCRs and sequencing. This new multiplex PCR is a simple, rapid, sensitive, specific, and cost-effective method for detection of 4 viruses in clinical specimens.

[Quality of life in low income Korean aged].

PURPOSE: The purpose of this study was to identify the quality of life and its predictors in low income Korean aged. METHODS: This was a predictive correlational study. An accessible sample from the population of people who were 65 and over and were supported by the basic livelihood security system was 1,040. Quota sampling with strata of state division in the nation was chosen. Quality of life and its predictors in the subjects were measured. RESULTS: The mean quality of life in the subjects was 47.0+/-10.7. Predictors of this study significantly explained 54.3% of the total variance of quality of life. Depression was the most significant predictor of quality of life. Health problems, district, social support, leisure activity, and health behavior had effects on quality of life. CONCLUSION: This finding indicates that quality of life in lower income Korean aged is different from other populations by economic status. Demographics, health status and social status were predictors of quality of life in the aged with a small income.