ABSTRACT
The objective of the current study was to investigate the perspectives of nursing home (NH) providers regarding the requirements to achieve reimbursement for nursing restorative care (NRC) services and propose recommendations to state agencies to assist NH providers to conduct NRC programs that are person-centered and able to achieve full reimbursement. Methods included a survey of NH providers in one state and a stakeholder focus group to discuss survey findings and develop recommendations. Key findings are that NH providers perceive value to residents from the provision of NRC; providers do not associate these benefits with the stringent reimbursement requirements; and NHs often provide NRC that is individualized, based on resident goals and activity tolerance, as well as realistic given competing demands on staff, even when doing so means giving up reimbursement for NRC services. Recommendations include basing reimbursement for NRC on outcomes rather than the process; reconsideration of the frequency and intensity requirements for NRC components; and increased availability of NRC training/education and resources for providers and case-mix reviewers. [Journal of Gerontological Nursing, 45(5), 5-10.].
Subject(s)
Geriatric Nursing/economics , Geriatric Nursing/standards , Long-Term Care/economics , Long-Term Care/standards , Patient-Centered Care/economics , Patient-Centered Care/standards , Rehabilitation Nursing/standards , Adult , Aged , Aged, 80 and over , Chronic Disease/economics , Chronic Disease/rehabilitation , Female , Humans , Male , Middle Aged , Nursing Homes/economics , Nursing Homes/standards , Practice Guidelines as Topic , United StatesSubject(s)
Geriatric Nursing , Health Policy , Health Services Needs and Demand , Aged , Geriatric Nursing/economics , Humans , Latin America , Long-Term CareABSTRACT
BACKGROUND: Community Nurse Supporting Elderly iN a changing SOciety is a project funded by the European Union, which is aimed at developing an innovative care model based on community nurses to support active ageing in mountain areas. The planned sustainability of this innovative approach relies on social entrepreneurship, and this work highlights the necessary conditions for the existence of these entrepreneurial initiatives on the market, with community nurses' services purchased by the public health care system. METHODS: The authors propose a sustainability framework for this project based on three relevant dimensions (ie, health, organisation, and context), highlighting the necessary conditions for continued provision of health services beyond project conclusion. Then, considering the Piedmont Region and those aged 65 or older as target population, health outcomes are analysed, proposing a break-even analysis to calculate expected levels. RESULTS: According to our results, in order to care for 191 977 elderly people for 3 years, a successful pro-active approach is needed to prevent 1657 falls with hip fracture, reducing the prevalence of this adverse outcome by 36%. These are the expected health outcome levels for the existence of a social market, which can be achieved through the successful involvement of local public health organisations and stakeholders. CONCLUSIONS: Policy makers need clear information on the economic impact of extending this new intervention to the whole target population and on the required preconditions for its financial sustainability in terms of health outcomes. However, a participatory process involving all relevant local stakeholders and organisations is crucial to extend current achievements beyond project conclusion.
Subject(s)
Community Health Nursing , Geriatric Nursing , Healthy Aging , Aged , Community Health Nursing/economics , Community Health Nursing/methods , Community Health Nursing/organization & administration , Geriatric Nursing/economics , Geriatric Nursing/methods , Geriatric Nursing/organization & administration , Health Care Costs , Humans , Italy , Program EvaluationSubject(s)
Geriatric Nursing/economics , National Health Programs/economics , Population Growth , Aged , Aged, 80 and over , Career Choice , Cost Control/trends , Forecasting , Geriatric Nursing/education , Geriatric Psychiatry/education , Health Services Needs and Demand/economics , Humans , Inservice Training , Interdisciplinary Communication , Intersectoral Collaboration , Switzerland , WorkforceSubject(s)
Ethics, Nursing , Geriatric Nursing/economics , Geriatric Nursing/trends , Inventions/economics , Inventions/trends , Population Dynamics/trends , Aged , Aged, 80 and over , Artificial Intelligence/economics , Artificial Intelligence/ethics , Artificial Intelligence/trends , Forecasting , Geriatric Nursing/ethics , Humans , Internet/economics , Internet/ethics , Internet/trends , Inventions/ethics , Leadership , Mobile Applications/economics , Mobile Applications/ethics , Mobile Applications/trends , Robotics/economics , Robotics/ethics , Robotics/trends , Smartphone/economics , Smartphone/trends , SwitzerlandSubject(s)
Curriculum/trends , Education, Nursing/economics , Education, Nursing/organization & administration , Geriatric Nursing/economics , Geriatric Nursing/education , Health Care Reform/economics , Health Care Reform/legislation & jurisprudence , Legislation, Nursing/economics , Legislation, Nursing/trends , Pediatric Nursing/economics , Pediatric Nursing/education , Cost-Benefit Analysis/economics , Cost-Benefit Analysis/legislation & jurisprudence , Education, Nursing/legislation & jurisprudence , Geriatric Nursing/legislation & jurisprudence , Germany , Health Care Reform/organization & administration , Humans , Pediatric Nursing/legislation & jurisprudence , Quality Assurance, Health Care/economics , Quality Assurance, Health Care/legislation & jurisprudence , Quality Assurance, Health Care/trendsSubject(s)
Career Choice , Economic Competition/economics , Economic Competition/legislation & jurisprudence , Employment/economics , Employment/legislation & jurisprudence , Job Satisfaction , Salaries and Fringe Benefits/economics , Salaries and Fringe Benefits/legislation & jurisprudence , Contract Services/economics , Contract Services/legislation & jurisprudence , Geriatric Nursing/economics , Geriatric Nursing/legislation & jurisprudence , Germany , HumansSubject(s)
Career Choice , Job Satisfaction , Nursing Staff/economics , Nursing Staff/supply & distribution , Salaries and Fringe Benefits/economics , Salaries and Fringe Benefits/legislation & jurisprudence , Unemployment , Geriatric Nursing/economics , Geriatric Nursing/legislation & jurisprudence , Germany , Home Care Services/economics , Home Care Services/legislation & jurisprudence , Home Care Services/supply & distribution , Humans , Work Schedule ToleranceSubject(s)
Dementia/complications , Dementia/economics , Geriatric Nursing/economics , Geriatric Nursing/statistics & numerical data , Health Care Costs/statistics & numerical data , Hospitalization/economics , Hospitalization/statistics & numerical data , Aged , Aged, 80 and over , Australia , Delirium/economics , Dementia/nursing , Humans , Middle Aged , Pneumonia/economics , Pressure Ulcer/economics , State Medicine/statistics & numerical data , Urinary Tract Infections/economicsSubject(s)
Geriatric Nursing/economics , Geriatric Nursing/organization & administration , Home Care Services/economics , Home Care Services/organization & administration , Population Dynamics , Professional Autonomy , Aged , Costs and Cost Analysis , Health Services Needs and Demand/economics , Health Services Needs and Demand/organization & administration , Humans , SwitzerlandABSTRACT
How sad to read that care home nursing is seen as 'something people do when they cannot get a job elsewhere' (News, April 29). I chose care home nursing straight out of university.