Does Nursing Home Ownership Change Affect Family Ratings on Experience with Care?

Person-centeredness may suffer in nursing homes (NHs) with recent ownership changes. This study identifies associations between ownership change and reported care experiences, important measures of person-centered care for long-term residents in Maryland NHs. Care experience measures and ownership change data were collected from Maryland Health Care Commission reports, which reported data on 220 Maryland NHs from 2011 and 2012. Facility and market covariates were obtained from 2011 NH Compare and Area Health Resource Files. Linear regression was used to examine whether ownership change in 2011 was associated with lower care experience ratings reported during April to June 2012. Dependent variables were overall care rating (scale 1–10), percentage of respondents answering that they would recommend the NH, and assessments of five care and resident life domains (scale 1–4). Care experiences reported in 2012 were high; however, after controlling for covariates, ownership change was associated with significant decreases in 6 out of 7 measures, including a 0.39-point decrease in overall care rating (p = .001). NH managers and policy makers should consider strategies to improve patient-centeredness after ownership change.     

Conditions for Exercising Residents’ Voting Rights in Long-Term Care Residences: A Prospective Multicenter Study

To assess voting conditions in long-term care settings, we conducted a multicenter survey after the 2009 European elections in France. A questionnaire about voting procedures and European elections was proposed in 146 out of 884 randomized facilities. Sixty-four percent of facilities answered the questionnaire. Four percent of residents voted (national turnout: 40%), by proxy (58%) or at polling places (42%). Abstention related to procedural issues was reported in 32% of facilities. Sixty-seven percent of establishments had voting procedures, and 53% declared that they assessed residents’ capacity to vote. Assistance was proposed to residents for voter registration, for proxy voting, and for voting at polling places, respectively, in 33%, 87%, and 80% of facilities. This survey suggests that residents may be disenfranchised and that more progress should be made to protect the voting rights of residents in long-term care facilities.     

The influence of the economic crisis on quality of care for older people: system readiness for innovation in Europe

The aim of this study is to examine the influence of the recent economic crisis on the quality of long-term care for older people in Belgium and the Netherlands. A mixed-method approach was applied, primarily focused on conducting semi-structured qualitative interviews with health professionals working in a management role in organizations providing long-term care for older people. The results show that Dutch organizations seem to be prepared for the influences of the economic crisis on the quality of its care provision primarily in terms of a sound system readiness. At the same time, Belgian organizations seem to be prepared for the influences of the economic crisis on the quality of its care provision primarily in terms of a favorable sociopolitical context. Comparing two countries allows for reciprocal lesson-drawing. The conclusion drawn in this study is that a sustainable long-term care system requires above all stability and structure.     

Difference and equality: Icelandic parents' division of parental leave within the context of a childcare gap

Iceland's parental leave system, granting mothers and fathers equal benefits, may be interpreted as part of the development in the Nordic countries towards a dual-earner/dual-caregiver model. Even though uptake studies show fathers' increased participation in childcare, the use of the entitlement varies and a gendered pattern persists. This paper is based on interviews with 14 Icelandic couples who find themselves in a situation where they have to bridge a care gap between parental leave and state-subsidized childcare. While mothers tend to stretch their part of the leave on the argument that six months is too short a leave, fathers generally find three months to be long enough. The discussion revolves around the question of the relationship between difference and equality, inspired by Andrea Doucet's (2006) concept of strategic essentialism. May we envision a policy system that takes into consideration the way people invest in gender and at the same time develop policy measures that facilitate gender equality?     

Explorative study into support needs of caregivers in short-term foster care regarding problem behaviour and dealing with biological parents

Family supporting foster care (FSFC) is a directly accessible, short-term and preventive form of foster care for children under the age of 12. Caregivers in this type of foster care need comprehensive support to deal with their complex tasks. In this contribution, the support needs arising from the behaviour of the foster child as well as concerning dealing with the biological parents of 85 Flemish FSFC-parents are examined, as these are areas FSFC-parents specifically ask support for. These support needs are evaluated for possible links with child and foster parent characteristics. More experienced foster parents and foster parents with a foster child showing more externalising problem behaviour ask for more support in managing the child's behaviour.     

One million and counting: the hidden army of young carers in Canada

The term ‘young carer’ refers to those youth under the age of 25 years who provide substantial unpaid support to a family member due to factors including, but not limited to, familial or parental absence, disability, mental health issue(s) or problems with alcohol and/or other drugs. In the UK, national statistics have been integral to tracking the prevalence of young carers while serving as an important tool towards the development of (and justification for) a national legislative framework supporting these youth. In Canada, research and awareness for young carers remains in its infancy and available national datasets have yet to be examined in relation to youths providing unpaid caregiving. As a result, this research provides the first trend analysis of youth-based caregiving in Canada using census data for the 1996–2006 time-period. Methodological limitations of official statistics are also discussed in terms of conceptual and operational constraints limiting the full identification of all those potential young carers.     

Mental Disabilities in an Aboriginal Context

Aboriginal (meaning original peoples) North American mental health is acknowledged to be in a more precarious state than that of the dominant cultures. Disability arises from the conditions of poverty, homelessness, and lack of resources that are compounded for North American aboriginal people by the historical trauma of conquest, being placed on reservations, residential schools, and continued discrimination. We present culturally sensitive and syntonic intervention programs that can reduce the impact of Aboriginal mental disabilities and discuss the commonality among these programs of celebrating culture, language, and tradition.     

Assessment of Patient Classification in Appointment System Design

This paper investigates two approaches to patient classification: using patient classification only for sequencing patient appointments at the time of booking and using patient classification for both sequencing and appointment interval adjustment. In the latter approach, appointment intervals are adjusted to match the consultation time characteristics of different patient classes. Our simulation results indicate that new appointment systems that utilize interval adjustment for patient class are successful in improving doctors' idle time, doctors' overtime and patients' waiting times without any trade‐offs. Best performing appointment systems are identified for different clinic environments characterized by walk‐ins, no‐shows, the percentage of new patients, and the ratio of the mean consultation time of new patients to the mean consultation time of return patients. As a result, practical guidelines are developed for managers who are responsible for designing appointment systems.     

Operations in the Service Industries: Introduction to the Special Issue

This special issue of Production and Operations Management offers a sample of ongoing research that focuses currently on the services industries. The articles selected cover a spectrum of application areas as well as methodologies.