An International Mapping of Medical Care in Nursing Homes

Abstract

Nursing home (NH) residents are increasingly in need of timely and frequent medical care, presupposing not only available but perhaps also continual medical care provision in NHs. The provision of this medical care is organized differently both within and across countries, which may in turn profoundly affect the overall quality of care provided to NH residents. Data were collected from official legislations and regulations, academic publications, and statistical databases. Based on this set of data, we describe and compare the policies and practices guiding how medical care is provided across Canada (2 provinces), Germany, Norway, and the United States. Our findings disclose that there is a considerable difference to find among jurisdictions regarding specificity and scope of regulations regarding medical care in NHs. Based on our data, we construct 2 general models of medical care: (1) more regulations—fee-for-service payment—open staffing models and (2) less regulation—salaried positions—closed staffing models. Some evidence indicates that model 1 can lead to less available medical care provision and to medical care provision being less integrated into the overall care services. As such, we argue that the service models discussed can significantly influence continuity of medical care in NH.

Course of activities of daily living in nursing home residents with dementia from admission to 36-month follow-up

“…In Norway, unlike many other countries, the health care services are public [4,5]. The primary health care service is, by law, managed by the local municipalities [6].…”

How Do German General Practitioners Assess Medical Specialist Care Needs of Nursing Home Residents? Results of a Postal Survey in North-Western Germany

“…A stronger role of GPs in nursing home care might prevent some nursing home residents from avoidable hospital admissions [ 15 ]. There is some evidence that health care systems that ensure a greater continuity of care by employing salaried GPs in nursing homes are associated with an overall better quality of care [ 17 ].…”

“…The transition to a nursing home does not automatically lead to a change of the GP or other physicians but might do so, for example, if the distances between the practice and the nursing home are too far. There are no regulations regarding which and how many GPs and medical specialist provide care for the residents of a nursing home and only a minority of facilities have formalized arrangements for cooperation between GPs and nursing home staff [ 17 ].…”

Epidemiology of COVID-19 outbreaks in aged care facilities during postvaccine period: a systematic review and meta-analysis

“…ACFs also known as residential care or long-term care (LTC) homes or nursing homes provide institutional care to an individual including their daily needs and personal care. Often the residents in ACFs have complex social, psychological and medical needs 10. COVID-19 pandemic highlighted the lack of preparation, prevention and mitigation strategies against infectious diseases in these congregate settings 11.…”