VARIATIONS IN OUTCOMES OF CARE IN URBAN AND RURAL NURSING FACILITIES IN MAINE

Federal and state regulators and the nursing home industry have accele rated efforts to improve care practices in response to the Institute o f Medicine's 1986 report on the quality of nursing home care and the f ederal Nursing Horne Reform Act of 1987 (OBRA 1987). Very little is kn own about the quality of care in rural nursing facilities compared to their urban counterparts. This study describes variations in facility and resident characteristics of urban and rural nursing facilities in Maine and examines differences in outcomes of care. The study estimate s rural-urban differences in II quality indicators (measured at the fa cility level) controlling for resident, facility and market characteri stics and other factors that may affect quality. Results reveal few si gnificant differences between rural and urban nursing facilities. Furt her research is needed to understand whether differences in the charac teristics of rural and urban facilities not measured in this study may affect nursing facility quality.