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.

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:...

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Publicado en:Journal of Korean Gerontological Nursing Vol. 27; no. 4; pp. 349 - 364
Autores principales: Lee, Hee Seung, Lee, Jung Suk
Formato: research tables/charts Journal Article
Publicado: Korean Gerontological Nursing Society Nov2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2025
      vid: 27
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      pub: Korean Gerontological Nursing Society
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        10.17079/jkgn.2025.00185
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        atl: 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.
      aug:
        au:
          Lee, Hee Seung
          Lee, Jung Suk
        affil: Associate Research Fellow, Health Insurance Research Institute, National Health Insurance Service, Wonju, Korea.
      sug:
        subj:
          Urinary Tract Infections Risk Factors
          Pressure Ulcer Risk Factors
          Risk Assessment
          Nursing Home Residents South Korea
          Insurance, Health South Korea
          Clinical Indicators
          Funding Source
          South Korea
          Human
          Retrospective Design
          Multiple Logistic Regression
          Descriptive Statistics
          Sex Factors
          Odds Ratio
          Confidence Intervals
          Functional Status
          Catheters, Urinary
          Quality Improvement
          Prediction Models
          Long Term Care
          Questionnaires
          Comorbidity
          Low Socioeconomic Status
          Health Status
          Health Status Indicators
          Mortality Risk Factors
          Organizational Structure
          Organizational Culture
          Intraclass Correlation Coefficient
          Multivariate Analysis
          Univariate Statistics
          Male
          Female
          Aged
          Aged, 80 and Over
          Age Factors
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: 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.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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