The Effect of Business Operating Systems on Nursing Home Termination

Xueying Jin; Kazuaki Uda; Miho Ishimaru; Tomomi Kihara; Takehiro Sugiyama; Kazumasa Yamagishi; Hiroyasu Iso; Nanako Tamiya

doi:10.3389/ijph.2023.1605439

The Effect of Business Operating Systems on Nursing Home Termination

Int J Public Health. 2023 Feb 1:68:1605439. doi: 10.3389/ijph.2023.1605439. eCollection 2023.

Authors

Xueying Jin^{1

2}, Kazuaki Uda³, Miho Ishimaru^{2

4}, Tomomi Kihara⁵, Takehiro Sugiyama^{2

3

6

7}, Kazumasa Yamagishi⁵, Hiroyasu Iso⁶, Nanako Tamiya^{2

3}

Affiliations

¹ Department of Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
² Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan.
³ Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
⁴ Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
⁵ Department of Public Health Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
⁶ Institute for Global Health Policy, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
⁷ Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.

Abstract

Objectives: Nursing home terminations have increased worldwide due to rising costs, staffing shortages, and the coronavirus disease pandemic. However, little is known about the impact that business operating systems have on nursing home termination. Methods: This study used the National Long-term Care database, which comprised 7,842 operating nursing homes in January 2018. Nursing home termination was identified when nursing homes discontinued provision of long-term care services to all residents between January 2018 and December 2020. Business operating systems that were reimbursed by the LTC insurance system were the exposure of interest. The logistic regression model for nursing home termination included a series of organizational, internal, and external factors as covariates. Results: From 2018 to 2020, 83 (1.1%) nursing homes were terminated. The proportion of reimbursed nursing homes varied greatly depending on the type of business operating systems. Implementing physical function training and improving working conditions were significantly associated with a lower risk of nursing home termination. Conclusion: Financial incentives to several business operating systems are an effective way to build a sustainable environment for nursing homes to continue to exist.

Keywords: additional payment; business operating system; financial incentives; long-term care insurance; nursing home termination.

MeSH terms

Humans
Nursing Homes*
Workforce

Grants and funding

This work was supported by MHLW Special Research Program (Grant Number JPMH20CA2046) and MHLW Research Program on Emerging and Reemerging Infectious Diseases (Grant Number JPMH21HA2011). The funders had no role in the study’s design, data collection, analysis, publication decisions, or manuscript preparation.