Factor Substitution and Inappropriate Use of Antipsychotics in Nursing Homes
نویسندگان
چکیده
Antipsychotics are indicated to treat schizophrenia and other psychotic disorders, but nursing homes have been criticized previously for using them as chemical restraints to treat behavior problems, especially for residents with dementia. We find that nearly one-in-four nursing home residents with dementia that lack severe behavioral symptoms are prescribed an antipsychotic medication. Using an instrumental variables approach, we investigate whether an increase in nursing home wages leads to greater substitution towards antipsychotic medications. Our results suggest a $100 increase in weekly nursing home wages increases the inappropriate use of antipsychotics among dementia patients by 2% to 6.5%. This finding suggests policymakers should consider nursing home market factors when overseeing and regulating issues of nursing home quality. JEL Codes: I12, L1, J4
منابع مشابه
A Review of Adverse Outcomes Associated with Psychoactive Drug Use in Nursing Home Residents with Dementia.
Treatment guidelines generally recommend careful assessment and non-pharmacological treatment approaches for behavioural and psychological symptoms of dementia. However, the inappropriate use of psychoactive drugs in patients with dementia in nursing homes is still prevalent. The aim of this narrative review is to summarise and criticize the most recent data investigating the adverse outcomes r...
متن کاملAppropriate prescribing in nursing homes demonstration project (APDP) study protocol: pragmatic, cluster-randomized trial and mixed methods process evaluation of an Ontario policy-maker initiative to improve appropriate prescribing of antipsychotics
BACKGROUND Antipsychotic medications are routinely prescribed in nursing homes to address the behavioral and psychological symptoms of dementia. Unfortunately, inappropriate prescribing of antipsychotic medications is common and associated with increased morbidity, adverse drug events, and hospitalizations. Multifaceted interventions can achieve a 12-20 % reduction in antipsychotic prescribing ...
متن کاملPatterns and Behavioural Outcomes of Antipsychotic Use among Nursing Home Residents: a Canadian and Swiss Comparison
ii I hereby declare that I am the sole author of this thesis. This is a true copy of the thesis, including any required final revisions, as accepted by my examiners. I understand that my thesis may be made electronically available to the public. iii ABSTRACT Background. Although antipsychotic medications are primarily intended to treat schizophrenia and psychotic symptoms in adults, they are co...
متن کاملResponse to regulatory stringency: the case of antipsychotic medication use in nursing homes.
This paper studies the impact of regulatory stringency, as measured by the statewide deficiency citation rate over the past year, on the quality of care provided in a national sample of nursing homes from 2000 to 2005. The quality measure used is the proportion of residents who are using antipsychotic medication. Although the changing case-mix of nursing home residents accounts for some of the ...
متن کاملAn educational intervention on drug use in nursing homes improves health outcomes resource utilization and reduces inappropriate drug prescription.
OBJECTIVE Inappropriate drug prescription is a common problem in people living in nursing homes and is linked to adverse health outcomes. This study assessed the effect of an educational intervention directed to nursing home physicians in reducing inappropriate prescription and improving health outcomes and resource utilization. DESIGN Prospective, randomized, multicenter study. SETTING A p...
متن کامل