Table 4.
Adjusted odds ratios (95% confidence intervals) for antipsychotic use associated with facility characteristics (DAL and LTC)
| Facility characteristics (added to multivariable models one at a time) | Odds ratio (95% confidence interval) | |
|---|---|---|
| DAL (n = 1089)a | LTC (n = 1000)b | |
| Dementia beds | 1.61 (1.07–2.44)* | 1.03 (0.72–1.48) |
| Ownership | ||
| For-profit (ref gp) | 1.00 | 1.00 |
| Not-for-profit or RHA | 0.76 (0.50–1.15) | 0.82 (0.57–1.18) |
| Part of a chain | ||
| Not in a chain (ref gp) | 1.00 | 1.00 |
| Part of [AL or LTC] chain | 0.57 (0.31–1.05)** | 0.98 (0.65–1.47) |
| Part of AL and LTC chain | 0.83 (0.50–1.35) | 1.05 (0.69–1.61) |
| Level of care | ||
| Specified level only or specified level + equivalent/lower (ref gp) | 1.00 | 1.00 |
| Specified level + higher | 0.70 (0.42–1.17) | 0.87 (0.52–1.46) |
| LPN/RN coverage on sitec | ||
| Neither on site (ref gp) | 1.00 | |
| LPN and/or RN <24/7 | 1.13 (0.57–2.26) | |
| LPN and/or RN 24/7 | 1.34 (0.88–2.02) | |
| Physician (GP) affiliated with site | ||
| No (ref gp) | 1.00 | 1.00 |
| Yes, no office on site | 0.97 (0.53–1.77) | 0.81 (0.57–1.14) |
| Yes, office on site | 1.01 (0.62–1.64) | 0.94 (0.59–1.49) |
| Pharmacist involved with site (past month)d | ||
| No (ref gp DAL) | 1.00 | |
| Yes, on staff (ref gp LTC) | 0.48 (0.23–1.03)** | 1.00 |
| Yes, as consultant | 1.25 (0.88–1.77) | 1.06 (0.75–1.49) |
| Health region | ||
| 1 (urban) (ref gp) | 1.00 | 1.00 |
| 2 (mixed urban/rural) | 0.58 (0.35–0.94)* | 1.19 (0.78–1.81) |
| 3 (rural) | 0.56 (0.30–1.05)** | 0.59 (0.35–0.97)* |
| 4 (urban) | 0.80 (0.49–1.30) | 1.09 (0.64–1.85) |
| 5 (rural) | 0.62 (0.30–1.26) | 1.35 (0.71–2.54) |
ABS Aggressive Behavior Scale, AL assisted living, DAL designated assisted living, GP general practitioner, LPN licensed practical nurse, LTC long-term care, ref gp reference group, RHA regional health authority, RN registered nurse
aFor DAL, each model adjusts for age, sex, dementia/treatment status, psychiatric diagnoses, presence of delusions/hallucinations, frailty status, cardiovascular diagnoses, cerebrovascular diagnoses, AL length of stay, ABS score, elopement attempts or threats, and use of antidepressant medications
bFor LTC, each model adjusts for age, sex, dementia/treatment status, psychiatric diagnoses, presence of delusions/hallucinations, frailty status, ABS score, elopement attempts or threats, wandering, use of physical restraints, and use of antidepressant, anxiolytic and sedative/hypnotic medications
cAll LTC facilities had 24/7 LPN/RN coverage, and thus the LPN/RN coverage variable was only considered for the DAL analyses
dAll LTC facilities had pharmacist involvement as either staff or consultant
* p < 0.05; ** p < 0.1