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* |