Which organizational characteristics are associated with increased management of depression using antidepressants in US nursing homes?

Medical Care
Kate L Lapane, Carmel M Hughes

Abstract

There is universal agreement that organizational characteristics of nursing facilities can and do influence the quality of care and resident outcomes. This study evaluated the relation between organizational characteristics and management of depression using antidepressants. This was a cross-sectional study of Medicare/Medicaid certified nursing homes in 6 states in 2000. We studied 87,907 residents with depression in 2,128 facilities. Minimum Data Set (MDS) provided information regarding use of antidepressants and resident factors. On-line Survey and Certification of Automated Records (OSCAR) provided facility characteristics information including structural, resource, and staffing levels. Adjusted estimates of organizational effects on antidepressant drug use were derived from generalized estimating equations. Increased treatment of depression with antidepressants was associated with facilities with a higher percentage of residents from payer sources other than Medicare/Medicaid (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02-1.06) and more professional nursing staff (OR, 1.15; 95% CI, 1.05-1.26). Decreased treatment tended to be related to larger homes (OR, 0.76; 95% CI, 0.68-0.84) or if the home employed full-tim...Continue Reading

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