Correlates of care quality in long-term care facilities: A multilevel analysis

Hierarchical modeling was employed to explore correlates of the quality of care provided in long-term care facilities. For this purpose, a multilevel analysis offers two advantages over traditional analytical approaches. Firs t, it accounts for the correlated nature of data recorded on multiple resid ents from the same facility. Second, it enables the investigators to study the influence of both resident and facility characteristics on care quality . The analysis was performed on data from 301 residents randomly sampled fr om 88 facilities located in the Province of Quebec, Canada. Results reveale d that the presence of cognitive deficits was the strongest correlate of th e quality of care provided to a resident However, this relationship was fou nd to vary significantly across facilities. Four facility-level variables w ere found to influence the relationship between cognitive functioning and c are quality: the number of external collaborators the facility has, the typ e of training the facility manager has, the site of the facility, and the a ge distribution of its clientele. From these results, we suggest means to i mprove the quality of care provided to cognitively impaired older adults li ving in long-term care facilities.