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Tom Solan MBBS BSc Daniel Cudini BEx Sci BEmergHlth GradDipEmergHlth MPA RP Matthew Humar BEmergHlth Nathan Forsyth BN MPHTM Ben Meadley PhD BAppSci DipParamedSci GradDipIntCareParamed GradDipEmergHlth GradCertEmergHlth Toby St. Clair DipEmergHlth GradDipEmergHlth GradCert Darren Hodge BASc Karen Smith BSc GradCertExecBA GradDipEpi&Biostats PhD Franz E Babl MD MPH DMedSc FRACP FAAP FACEP Elliot Long BMBS FRACP PhD 《Emergency medicine Australasia : EMA》2023,35(5):754-758
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Lindsey Smith Paula Carder Taylor Bucy Jaclyn Winfree Joan F. Brazier Brian Kaskie Kali S. Thomas 《Health services research》2021,56(3):540
ObjectiveTo document dementia‐relevant state assisted living regulations and their changes over time as they pertain to licensed care settings.Data SourcesFor all states, current directories of licensed assisted living communities and state regulations for each year, 2007‐2018, were obtained from state agency websites and Nexis Uni, respectively.Study DesignWe identified multiple types of regulatory classifications for each state and documented the presence or absence of specific dementia care provisions in the regulations for each type by study year. Maps and summary statistics were used to compare results to previous research and document change longitudinally.Data Collection/Extraction MethodsWe used a policy analysis approach to connect communities listed in directories to applicable regulatory text. Then, we employed policy surveillance and question‐based coding to record the presence or absence of specific policies for each classification and study year.Principal FindingsOur team empirically documented provisions requiring dementia‐specific training for administrators and direct care staff, and cognitive impairment screening for each study year. We found that 23 states added one or more of these requirements for one or more license types, but the states that had these provisions for all types of licensed assisted living declined from four to two.ConclusionsWe identified significant, previously undocumented, within‐state policy variation for assisted living licensed settings between 2007 and 2018. Using the regulatory classification instead of the state as the unit of analysis revealed that many policy adoptions were limited to dementia‐designated settings. This suggests that people living with dementia in general assisted living are not afforded the same protections. We call our approach health services regulatory analysis and argue that it has the potential to identify gaps in existing policies, an important endeavor for health services research in assisted living and other care settings. 相似文献
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