Paying A Heavy Price: Costs of Care for People with Severe Obesity in Nursing Homes.

disparities qualitative analysis reimbursement staffing thematic analysis

Journal

The Gerontologist
ISSN: 1758-5341
Titre abrégé: Gerontologist
Pays: United States
ID NLM: 0375327

Informations de publication

Date de publication:
31 Oct 2023
Historique:
received: 01 06 2023
medline: 2 11 2023
pubmed: 2 11 2023
entrez: 2 11 2023
Statut: aheadofprint

Résumé

The prevalence of resident obesity in nursing homes has increased dramatically from 22% to 28% between 2005 and 2015. To provide care for people with obesity, nursing homes have changed their admissions, staffing, and equipment, but underlying these changes are increased resources and financial costs of care. The purpose of this study is to describe nursing home organizational aspects of caring for older adults with obesity, with a focus on economic factors, from the perspective of nursing home staff and leadership. This qualitative study used descriptive approaches; data were collected through semi-structured telephone interviews. Of 77 nursing home staff and leaders identified as potential study participants, 6 were ineligible, and 71 participated in the study through interviews conducted from 2019 to 2022. Four primary themes described the issues surrounding cost of care for obesity in nursing homes: inefficient and risky use of staff time in a setting of persistent staff shortage, expensive and unique equipment needs, inadequate general reimbursement with an absence of obesity-specific reimbursement supplements, and competing short and long-term management solutions. This qualitative study of nursing home staff and leadership underscores a need for improved approaches to funding obesity care within existing nursing payment models. The increasing prevalence of obesity and the burden of the costs of obesity care for nursing homes will escalate this need over the coming decade.

Sections du résumé

BACKGROUND AND OBJECTIVES OBJECTIVE
The prevalence of resident obesity in nursing homes has increased dramatically from 22% to 28% between 2005 and 2015. To provide care for people with obesity, nursing homes have changed their admissions, staffing, and equipment, but underlying these changes are increased resources and financial costs of care. The purpose of this study is to describe nursing home organizational aspects of caring for older adults with obesity, with a focus on economic factors, from the perspective of nursing home staff and leadership.
RESEARCH DESIGN AND METHODS METHODS
This qualitative study used descriptive approaches; data were collected through semi-structured telephone interviews. Of 77 nursing home staff and leaders identified as potential study participants, 6 were ineligible, and 71 participated in the study through interviews conducted from 2019 to 2022.
RESULTS RESULTS
Four primary themes described the issues surrounding cost of care for obesity in nursing homes: inefficient and risky use of staff time in a setting of persistent staff shortage, expensive and unique equipment needs, inadequate general reimbursement with an absence of obesity-specific reimbursement supplements, and competing short and long-term management solutions.
DISCUSSION AND IMPLICATIONS CONCLUSIONS
This qualitative study of nursing home staff and leadership underscores a need for improved approaches to funding obesity care within existing nursing payment models. The increasing prevalence of obesity and the burden of the costs of obesity care for nursing homes will escalate this need over the coming decade.

Identifiants

pubmed: 37915117
pii: 7334205
doi: 10.1093/geront/gnad150
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Luisa Fernandez (L)

Department of Earth and Environmental Sciences. University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Bianca Shieu (B)

Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Alison Trinkoff (A)

Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, Maryland, USA.

Nicholas Castle (N)

Department of Health Policy and Management, School of Public Health, West Virginia University, Morgantown, West Virginia, USA.

David G Wolf (DG)

College of Business and Management, Lynn University, Boca Raton, Florida, USA.

Steven Handler (S)

VA Pittsburgh Healthcare System and Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

John Harris (J)

Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Classifications MeSH