|Title||Nursing home placement among older adults: A national study of risk perceptions, access and placement outcomes|
|Year of Publication||2007|
|University||University of Iowa|
|Keywords||Demographics, Healthcare, Nursing homes, Older Adults, Risk Factors|
In health services research, race and gender are frequently included as demographic variables along with other relevant predictors. Frequently, however, routine inclusion of race and gender is of a cursory nature, and does not inform researchers of the great differences that can be evident between groups. To address this, particularly in long-term care research, the principle purpose of this dissertation research was to explore the additive and interactive effects of race and gender on several aspects of nursing home use including expectations for placement, the risk for placement, access to nursing home services, and outcomes of nursing home use. Data were drawn from the Health and Retirement Study, specifically, the study on Asset and Health Dynamics among the Oldest Old (AHEAD). 7,447 AHEAD study respondents were 70 years and older at baseline data collection in 1993. The observation period lasted through 2004. Multivariate binary and multinomial logistic regression models, as well as ordinary least squares, and hazard modeling techniques were used. Study results confirmed that risk perceptions as reported by respondents were rational, and that older adults can accurately assess their risk for placement in 5 years. Overwhelmingly, Blacks were at a lower risk for placement in a nursing home in 5 years, or after 11 years. However, the risk for placement was significantly impacted by the growth of assisted living beds over the study period which expanded access for Whites, but limited long-term care options for Blacks to nursing homes. Women experienced higher risk for placements, especially multiple placements over time, suggesting a possible reliance on nursing homes for respite care due to more limited caregiver options in the community. Study results suggest that early identification of individuals at risk informs budget planning for Medicaid and other payers, and directs resources to individuals and communities that are in greatest need. Planning for the anticipated growth in the need for long-term care services are also improved by identifying demographic and other personal and market factors that contribute to temporary, multiple, or terminal use of long-term care services by older adults.
|Short Title||Nursing home placement among older adults: A national study of risk perceptions, access and placement outcomes|