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Consistency of priorities for quality improvement for nursing homes in Italy and Canada: A comparison of optimization models of resident satisfaction

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  • Barsanti, Sara
  • Walker, Kevin
  • Seghieri, Chiara
  • Rosa, Antonella
  • Wodchis, Walter P.

Abstract

The paper seeks to identify aspects of care that may be easily modified to yield a desired level of improvement in residents' overall satisfaction with nursing homes, comparing data across Canada and Italy. Using a structured questionnaire, 681 and 1116 nursing home residents were surveyed in Ontario in 2009 and in Tuscany in 2012, respectively. Fourteen items were common to the surveys, including willingness to recommend (WTR), which was used as the dependent variable and measure of global satisfaction. The other analogous items were entered as covariates in ordinal logistic regression models predicting residents' WTR in each jurisdiction separately. Regression coefficients were then incorporated into a constrained nonlinear optimization problem selecting the most efficient combination of predictors necessary to increase WTR by as much as 15%. Staff-related aspects of care were selected first in the optimization models of each jurisdiction. In Ontario, to improve WTR the primary focus should be on staff relationships with residents, while in Tuscany it was the technical skill and knowledge of staff that was selected first by the optimization model. Different optimization solutions might mean that the strategies required to improve global satisfaction in one jurisdiction could be different than those for the other jurisdictions. The optimization model employed provides a novel solution for prioritizing areas of focus for quality improvement for nursing homes.

Suggested Citation

  • Barsanti, Sara & Walker, Kevin & Seghieri, Chiara & Rosa, Antonella & Wodchis, Walter P., 2017. "Consistency of priorities for quality improvement for nursing homes in Italy and Canada: A comparison of optimization models of resident satisfaction," Health Policy, Elsevier, vol. 121(8), pages 862-869.
  • Handle: RePEc:eee:hepoli:v:121:y:2017:i:8:p:862-869
    DOI: 10.1016/j.healthpol.2017.06.004
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    References listed on IDEAS

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    1. Nuti, Sabina & Seghieri, Chiara, 2014. "Is variation management included in regional healthcare governance systems? Some proposals from Italy," Health Policy, Elsevier, vol. 114(1), pages 71-78.
    2. De Rosis, Sabina & Barsanti, Sara, 2016. "Patient satisfaction, e-health and the evolution of the patient–general practitioner relationship: Evidence from an Italian survey," Health Policy, Elsevier, vol. 120(11), pages 1279-1292.
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