Table 1

Relationship between financial performance (profitable, stable and unprofitable) and management of home-visit nursing agency (in September 2012) (n = 1204, 100%)
Variables Profitable Stable Unprofitable
n = 582 (48.3%) n = 380 (31.6%) n = 242 (20.1%) p value A)
A. Operating structure Average ± Standard deviation or number of subjects (%)
Establishment year of a home-visit nursing agency 2000 ± 5.5 2001 ± 5.8 2001 ± 5.7 0.37
Establishment year of a home-visit nursing agency (2011 or later) 28 (4.8) 25 (6.6) 21 (8.7) 0.11
Number of other home-visit nursing agencies managed by the same corporation 7.0 ± 11.3 5.5 ± 8.9 6.6 ± 10.3 0.53
Owned by a hospital 236 (42.0) 133 (37.8) 118 (50.9) 0.007**
B. Management by a nurse manager
Years of experience of nurse manager 7.0 ± 5.0* 6.2 ± 4.7 5.7 ± 4.7 0.001**
Number of home visits per month by the nurse manager 52.0 ± 26.1 49.6 ± 25.0 39.8 ± 21.4 * <.001***
Experience of nurse manager in management training 421.0 (73.5) 252.0 (67.2) 147.0 (61.8) 0.003**
Nurse manager’s capability with financial management 342 (59.4) 195 (52.3) 104 (44.4) <.001***
C. Employment
Number of nursing staff (converted to full-time staff) 5.7 ± 3.5* 4.5 ± 2.3 4.1 ± 2.0 <.001***
Number of rehabilitation staff (converted to full-time staff)a 1.4 ± 2.9* 0.9 ± 1.9 0.6 ± 1.6 <.001***
Total number of staff (converted to full-time staff)b 8.3 ± 5.7* 6.4 ± 4.2 5.3 ± 3.2* <.001***
Ratio of nursing staff within total staffc 74.5 ± 20.6* 78.0 ± 20.4 83.5 ± 18.4* <.001***
Ratio of rehabilitation staff within total staffc 13.0 ± 17.3* 10.5 ± 16.3 7.0 ± 14.1* <.001***
Ratio of full-time staffd 69.8 ± 21.6 71.9 ± 22.7 75.2 ± 22.6 0.007**
D. Patient utilization
Number of patients using long-term care insurance 67.2 ± 49.5* 48.2 ± 35.3 33.8 ± 24.7* <.001***
Number of patients using medical insurance 23.2 ± 21.1* 15.7 ± 16.2 11.0 ± 10.0* <.001***
Total number of patients 89.6 ± 61.5* 62.8 ± 43.4 44.5 ± 28.8* <.001***
Number of patients per nursing staffe 18.1 ± 16.8* 14.5 ± 8.8 11.3 ± 7.0* <.001***
Percentage of patients covered by medical insurancee 25.6 ± 14.8 25.1 ± 16.7 26.1 ± 19.2 0.78
Number of new patients of medical insurance 3.4 ± 3.1* 2.4 ± 2.4 1.9 ± 2.1* <.001***
Number of new patients of long-term care insurance 2.0 ± 2.7* 1.2 ± 1.9 1.4 ± 3.2 <.001***
Percentage of new patientse 6.5 ± 4.8 6.4 ± 6.5 7.8 ± 11.4 0.04*
Percentage of bedridden patientsf 28.8 ± 17.2 30.2 ± 19.3 32.1 ± 21.6 0.09†
Percentage of patients who ended the service due to improvement 4.7 ± 6.1 6.1 ± 8.6 7.6 ± 10.9* <.001***
Percentage of patients who ended the service due to hospitalized 6.0 ± 8.0 5.8 ± 5.5 7.0 ± 11.9 0.22
Percentage of home deaths among terminal patientsg 70.3 ± 30.8 67.1 ± 34.8 62.1 ± 35.3 0.04*
E. Quality control (during the last year)
Planned learning opportunities per year for all staff members 524 (90.0) 327 (86.0) 212 (87.6) 0.16
Conducting regularly of patient satisfaction survey 236 (41.3) 127 (34.2) 91 (39.1) 0.11
Conducting regularly of care monitoring among staff 262 (45.9) 139 (37.5) 90 (38.6) 0.02*
Conducting regularly of control of staff objectives by nurse manager 323 (56.6) 136 (36.7) 94 (40.3) <.001***
Conducting regularly of visits of staff with nurse manager 166 (28.5) 112 (29.5) 67 (27.7) 0.89
F. Regional cooperation (during the last year)
Number of hospitals with cooperation in the community 27.7 ± 23.1* 20.2 ± 17.4 14.7 ± 12.9* <.001***
Activities for regional contribution: Open lecture for citizens 74 (13.1) 38 (10.2) 18 (7.7) 0.12
Activities for regional contribution: Required to serve as instructors at external lectures 238 (42.2) 100 (26.9) 63 (26.9) <.001***
Activities for regional contribution: Participation in meetings of local home-care related committees 211 (37.4) 98 (26.3) 61 (26.1) <.001***
Activities for regional contribution: Received consultations from other health professionals 367 (65.1) 222 (59.7) 129 (55.1) 0.02*
G. Financial condition
Proportion of total income covered by long-term care insurance 64.8 ± 18.0 65.5 ± 18.9 65.3 ± 20.1 0.83
Proportion of total income covered by medical insurance 35.2 ± 18.0 34.5 ± 18.9 34.7 ± 20.1 0.83
Proportion of expenditures going toward compensation 75.2 ± 11.9 73.7 ± 11.2 80.2 ± 9.7* <.001***
Compensation of full-time nursing staff 4996046.4 ± 2251701.0* 4517809.1 ± 2236688.5 4634608.1 ± 2386036.2 0.02*

AWhen the variable was continuous values, we performed one-way analysis of variance. Furthermore, when significant correlation was confirmed between the financial performance and the variables, we performed Dunnett multiple comparison to compare the “stable” group with “profitable” and “unprofitable” groups. When variables were categorical data, we performed chi-square test. ***P<.001, **P<.01, *P<.05, †P<.10.

a:Total number of physiotherapists, occupational therapists and speech therapists.

b:Total number of nursing staff, rehabilitation staff and office staff.

c:Number of nursing staff or rehabilitation staff converted to full-time staff/number of staff converted to full-time staff.

d:Number of full-time staff/number of staff converted to full-time staff.

e:Ratio (%) calculated using the total number of patients as the denominator during the 1-month study period (September 2012).

f: Ratio of independence in daily life C calculated using the total of J (independence), A (independence in a room), B (independence on the floor) and C (bedridden) as the denominator.

g:Number of patients died at home/number of patients who died after receiving terminal care during 6 months from April to September 2012.

Fukui et al.

Fukui et al. BMC Health Services Research 2014 14:11   doi:10.1186/1472-6963-14-11

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