| Sumario: | Purpose: Urinary tract infections (UTIs) and pressure injuries are critical quality indicators in long-term 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.
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