서브메뉴
검색
The Impact of Nursing Home Ownership on the Election of Advance Care Directives
The Impact of Nursing Home Ownership on the Election of Advance Care Directives
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202104844
- ISBN
- 9798293829415
- DDC
- 614
- 저자명
- Elie, Natasha.
- 서명/저자
- The Impact of Nursing Home Ownership on the Election of Advance Care Directives
- 발행사항
- [Sl] : The University of Alabama at Birmingham, 2025
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2025
- 형태사항
- 110 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 87-03, Section: A.
- 주기사항
- Advisor: Banaszak-Holl, Jane C.
- 학위논문주기
- Thesis (D.Sc.)--The University of Alabama at Birmingham, 2025.
- 초록/해제
- 요약Approximately 1.3 million people reside in nursing homes/facilities. Annually, this population represents 25% of mortalities in the United States. The enactment of the Patient Self Determination Act (PSDA) required nursing homes/facilities to educate patients, staff, and the community on the right to advance care directives. This study aimed to evaluate the impact of nursing home ownership on the election of ACDs and end-of-life care services by examining how nursing homes ownership in New York, California, and Ohio compared regarding residents' election of ACD and whether there was a variation in the these states. This paper contributes to the literature by evaluating factors predicting variation in the election of ACD and hospice care services, which can impact how regulatory approaches standardized election of ACDs. Design: Explanatory comparative mixed-method design. Setting and Participants: Nursing Home/Facilities and Licensed Nursing Home Administrators (LNHA) across three states, California, New York, and Ohio. Method: Retrospective analysis of the election of ACDs and the clinical characteristics of the nursing home patient based on the Minimum Data Set 2.0 and 3.0. Additionally, the researcher conducted focused interviews with LNHAs to evaluate the influence of ownership on ACDs and end-of-life services. Institutional/regulatory theory may explain the variation in the adoption of advance care planning across the states. Results: The sample comprised 5,512 nursing homes/facilities across three states: New York, California, and Ohio. In 2010, there were 2,781 nursing homes, of which 1,489 were for-profit facilities. By 2018, this number had slightly decreased to 2,631, with 2,148 still being for-profit facilities. Data analysis supported a statistically significant relationship with the election of Do Not Resuscitate with not-for-profit ownership in 2010 in California. LNHA interviews were conducted to provide deeper insights into how nursing home/facility ownership influences the election of advance care directives and end-of-life care services among nursing home/ facility patients. The study revealed state laws as well as ownership does influence the utilization of end-of-life services. Conclusion: Standardization of education for ACDs and end-of-life care will reduce the variability in the election of ACDs across states and healthcare settings; and there remains a need for standardization of end-of-life care.
- 일반주제명
- Public health
- 일반주제명
- Political science
- 일반주제명
- Public policy
- 키워드
- End-of-life care
- 기타저자
- The University of Alabama at Birmingham Health Professions
- 기본자료저록
- Dissertations Abstracts International. 87-03A.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
008260126s2025 us c eng d■001000017359168
■00520260202104844
■006m o d
■007cr#unu||||||||
■020 ▼a9798293829415
■035 ▼a(MiAaPQ)AAI32173391
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a614
■1001 ▼aElie, Natasha.
■24510▼aThe Impact of Nursing Home Ownership on the Election of Advance Care Directives
■260 ▼a[Sl]▼bThe University of Alabama at Birmingham▼c2025
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2025
■300 ▼a110 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 87-03, Section: A.
■500 ▼aAdvisor: Banaszak-Holl, Jane C.
■5021 ▼aThesis (D.Sc.)--The University of Alabama at Birmingham, 2025.
■520 ▼aApproximately 1.3 million people reside in nursing homes/facilities. Annually, this population represents 25% of mortalities in the United States. The enactment of the Patient Self Determination Act (PSDA) required nursing homes/facilities to educate patients, staff, and the community on the right to advance care directives. This study aimed to evaluate the impact of nursing home ownership on the election of ACDs and end-of-life care services by examining how nursing homes ownership in New York, California, and Ohio compared regarding residents' election of ACD and whether there was a variation in the these states. This paper contributes to the literature by evaluating factors predicting variation in the election of ACD and hospice care services, which can impact how regulatory approaches standardized election of ACDs. Design: Explanatory comparative mixed-method design. Setting and Participants: Nursing Home/Facilities and Licensed Nursing Home Administrators (LNHA) across three states, California, New York, and Ohio. Method: Retrospective analysis of the election of ACDs and the clinical characteristics of the nursing home patient based on the Minimum Data Set 2.0 and 3.0. Additionally, the researcher conducted focused interviews with LNHAs to evaluate the influence of ownership on ACDs and end-of-life services. Institutional/regulatory theory may explain the variation in the adoption of advance care planning across the states. Results: The sample comprised 5,512 nursing homes/facilities across three states: New York, California, and Ohio. In 2010, there were 2,781 nursing homes, of which 1,489 were for-profit facilities. By 2018, this number had slightly decreased to 2,631, with 2,148 still being for-profit facilities. Data analysis supported a statistically significant relationship with the election of Do Not Resuscitate with not-for-profit ownership in 2010 in California. LNHA interviews were conducted to provide deeper insights into how nursing home/facility ownership influences the election of advance care directives and end-of-life care services among nursing home/ facility patients. The study revealed state laws as well as ownership does influence the utilization of end-of-life services. Conclusion: Standardization of education for ACDs and end-of-life care will reduce the variability in the election of ACDs across states and healthcare settings; and there remains a need for standardization of end-of-life care.
■590 ▼aSchool code: 0005.
■650 4▼aPublic health
■650 4▼aPolitical science
■650 4▼aPublic policy
■653 ▼aAdvance care directives
■653 ▼aEnd-of-life care
■653 ▼aInstitutional theory
■653 ▼aNursing home ownership
■653 ▼aLicensed Nursing Home Administrators
■690 ▼a0769
■690 ▼a0630
■690 ▼a0615
■690 ▼a0573
■71020▼aThe University of Alabama at Birmingham▼bHealth Professions.
■7730 ▼tDissertations Abstracts International▼g87-03A.
■790 ▼a0005
■791 ▼aD.Sc.
■792 ▼a2025
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17359168▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
