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Table 1 Relationship between financial performance (profitable, stable and unprofitable) and management of home-visit nursing agency (in September 2012) (n = 1204, 100%)

From: Determinants of financial performance of home-visit nursing agencies in Japan

Variables

Profitable

Stable

Unprofitable

 

n = 582 (48.3%)

n = 380 (31.6%)

n = 242 (20.1%)

p value A)

A. Operating structure

Average ± Standard deviation or number of subjects (%)

  

Establishment year of a home-visit nursing agency

2000 ± 5.5

2001 ± 5.8

2001 ± 5.7

0.37

Establishment year of a home-visit nursing agency (2011 or later)

28 (4.8)

25 (6.6)

21 (8.7)

0.11

Number of other home-visit nursing agencies managed by the same corporation

7.0 ± 11.3

5.5 ± 8.9

6.6 ± 10.3

0.53

Owned by a hospital

236 (42.0)

133 (37.8)

118 (50.9)

0.007**

B. Management by a nurse manager

 

Years of experience of nurse manager

7.0 ± 5.0*

6.2 ± 4.7

5.7 ± 4.7

0.001**

Number of home visits per month by the nurse manager

52.0 ± 26.1

49.6 ± 25.0

39.8 ± 21.4 *

<.001***

Experience of nurse manager in management training

421.0 (73.5)

252.0 (67.2)

147.0 (61.8)

0.003**

Nurse manager’s capability with financial management

342 (59.4)

195 (52.3)

104 (44.4)

<.001***

C. Employment

 

Number of nursing staff (converted to full-time staff)

5.7 ± 3.5*

4.5 ± 2.3

4.1 ± 2.0

<.001***

Number of rehabilitation staff (converted to full-time staff)a

1.4 ± 2.9*

0.9 ± 1.9

0.6 ± 1.6

<.001***

Total number of staff (converted to full-time staff)b

8.3 ± 5.7*

6.4 ± 4.2

5.3 ± 3.2*

<.001***

Ratio of nursing staff within total staffc

74.5 ± 20.6*

78.0 ± 20.4

83.5 ± 18.4*

<.001***

Ratio of rehabilitation staff within total staffc

13.0 ± 17.3*

10.5 ± 16.3

7.0 ± 14.1*

<.001***

Ratio of full-time staffd

69.8 ± 21.6

71.9 ± 22.7

75.2 ± 22.6

0.007**

D. Patient utilization

 

Number of patients using long-term care insurance

67.2 ± 49.5*

48.2 ± 35.3

33.8 ± 24.7*

<.001***

Number of patients using medical insurance

23.2 ± 21.1*

15.7 ± 16.2

11.0 ± 10.0*

<.001***

Total number of patients

89.6 ± 61.5*

62.8 ± 43.4

44.5 ± 28.8*

<.001***

Number of patients per nursing staffe

18.1 ± 16.8*

14.5 ± 8.8

11.3 ± 7.0*

<.001***

Percentage of patients covered by medical insurancee

25.6 ± 14.8

25.1 ± 16.7

26.1 ± 19.2

0.78

Number of new patients of medical insurance

3.4 ± 3.1*

2.4 ± 2.4

1.9 ± 2.1*

<.001***

Number of new patients of long-term care insurance

2.0 ± 2.7*

1.2 ± 1.9

1.4 ± 3.2

<.001***

Percentage of new patientse

6.5 ± 4.8

6.4 ± 6.5

7.8 ± 11.4

0.04*

Percentage of bedridden patientsf

28.8 ± 17.2

30.2 ± 19.3

32.1 ± 21.6

0.09†

Percentage of patients who ended the service due to improvement

4.7 ± 6.1

6.1 ± 8.6

7.6 ± 10.9*

<.001***

Percentage of patients who ended the service due to hospitalized

6.0 ± 8.0

5.8 ± 5.5

7.0 ± 11.9

0.22

Percentage of home deaths among terminal patientsg

70.3 ± 30.8

67.1 ± 34.8

62.1 ± 35.3

0.04*

E. Quality control (during the last year)

 

Planned learning opportunities per year for all staff members

524 (90.0)

327 (86.0)

212 (87.6)

0.16

Conducting regularly of patient satisfaction survey

236 (41.3)

127 (34.2)

91 (39.1)

0.11

Conducting regularly of care monitoring among staff

262 (45.9)

139 (37.5)

90 (38.6)

0.02*

Conducting regularly of control of staff objectives by nurse manager

323 (56.6)

136 (36.7)

94 (40.3)

<.001***

Conducting regularly of visits of staff with nurse manager

166 (28.5)

112 (29.5)

67 (27.7)

0.89

F. Regional cooperation (during the last year)

 

Number of hospitals with cooperation in the community

27.7 ± 23.1*

20.2 ± 17.4

14.7 ± 12.9*

<.001***

Activities for regional contribution: Open lecture for citizens

74 (13.1)

38 (10.2)

18 (7.7)

0.12

Activities for regional contribution: Required to serve as instructors at external lectures

238 (42.2)

100 (26.9)

63 (26.9)

<.001***

Activities for regional contribution: Participation in meetings of local home-care related committees

211 (37.4)

98 (26.3)

61 (26.1)

<.001***

Activities for regional contribution: Received consultations from other health professionals

367 (65.1)

222 (59.7)

129 (55.1)

0.02*

G. Financial condition

 

Proportion of total income covered by long-term care insurance

64.8 ± 18.0

65.5 ± 18.9

65.3 ± 20.1

0.83

Proportion of total income covered by medical insurance

35.2 ± 18.0

34.5 ± 18.9

34.7 ± 20.1

0.83

Proportion of expenditures going toward compensation

75.2 ± 11.9

73.7 ± 11.2

80.2 ± 9.7*

<.001***

Compensation of full-time nursing staff

4996046.4 ± 2251701.0*

4517809.1 ± 2236688.5

4634608.1 ± 2386036.2

0.02*

  1. AWhen the variable was continuous values, we performed one-way analysis of variance. Furthermore, when significant correlation was confirmed between the financial performance and the variables, we performed Dunnett multiple comparison to compare the “stable” group with “profitable” and “unprofitable” groups. When variables were categorical data, we performed chi-square test. ***P<.001, **P<.01, *P<.05, †P<.10.
  2. a:Total number of physiotherapists, occupational therapists and speech therapists.
  3. b:Total number of nursing staff, rehabilitation staff and office staff.
  4. c:Number of nursing staff or rehabilitation staff converted to full-time staff/number of staff converted to full-time staff.
  5. d:Number of full-time staff/number of staff converted to full-time staff.
  6. e:Ratio (%) calculated using the total number of patients as the denominator during the 1-month study period (September 2012).
  7. f: Ratio of independence in daily life C calculated using the total of J (independence), A (independence in a room), B (independence on the floor) and C (bedridden) as the denominator.
  8. g:Number of patients died at home/number of patients who died after receiving terminal care during 6 months from April to September 2012.