Institutional and individual factors influencing urinary tract infections and pressure injuries in Korean nursing home residents: A multilevel analysis of National Health Insurance Service Data

• 발행기관: 한국노인간호학회
• 저자명: Hee Seung Lee Jung Suk Lee
• 간행물 정보: 『노인간호학회지』제27권 제4호, 349~363쪽, 전체 15쪽
• 주제분류: 의약학 > 의학일반
• 파일형태: PDF
• 발행일자: 2025.11.30

국문 초록

Purpose Urinary tract infections (UTIs) and pressure injuries are critical quality indicators in longterm care facilities (LTCFs). This study investigated the individual- and institutional-level factors associated with UTI and pressure injury experience among Korean nursing home residents. Method This retrospective study utilized the National Health Insurance Service database and analyzed 122,312 residents from 4,242 nursing homes who continuously resided for at least 3 months between January 2016 and December 2017. Multilevel logistic regression analyses were used to examine individual characteristics, facility attributes, and LTCF evaluation indicators. Results The UTI and pressure injury experience rates were 31.09% and 6.69%, respectively. Female residents exhibited significantly higher UTI risk (odds ratio [OR]=1.16, 95% confidence interval [95% CI]=1.13~1.21) but lower pressure injury risk (OR=0.73, 95% CI=0.69~0.78) than males. Lower functional grades demonstrated stepwise risk increases for both outcomes, with Grade 1 residents showing 2.97 times increased UTI risk and 8.35 times increased pressure injury risk. Facility size was a significant risk factor for UTI development. Condition-specific LTCF evaluation indicators for UTI and pressure injuries showed targeted protective effects: the Indwelling Catheter Status indicator reduced the UTI experience risk by 14%; the Pressure Injury Prevention indicator reduced the pressure injury experience risk by 12%. Conclusion This study identified distinct individual and institutional factors that influence adverse events in Korean nursing home residents. Condition-specific quality indicators demonstrated protective effects only for their corresponding outcomes, validating the effectiveness of tailored quality management approaches and supporting the development of targeted prevention strategies.

목차

INTRODUCTION

METHODS

RESULTS

DISCUSSION

CONCLUSION

REFERENCES

키워드

Long-term care Urinary tract infections Pressure ulcer Nursing homes