Risk of nursing home admission among older americans: does states' spending on home- and community-based services matter?

TitleRisk of nursing home admission among older americans: does states' spending on home- and community-based services matter?
Publication TypeJournal Article
Year of Publication2007
AuthorsMuramatsu, N, yin, H, Campbell, RT, Hoyem, RL, Jacob, MA, Ross, C
JournalJ Gerontol B Psychol Sci Soc Sci
Volume62
Issue3
PaginationS169-78
Date Published2007 May
ISSN Number1079-5014
Call Numbernewpubs20070611_Muramatsu_etal.pdf
KeywordsAged, Aged, 80 and over, Caregivers, Cohort Studies, Cost Savings, Cost-Benefit Analysis, Female, Financing, Government, Health Expenditures, Home Care Services, Homes for the Aged, Humans, Insurance Coverage, Long-term Care, Male, Medicaid, Medicare, Nursing homes, Patient Admission, Patient Readmission, Risk Assessment, Risk Factors, State Health Plans, United States
Abstract

OBJECTIVE: States vary greatly in their support for home- and community-based services (HCBS) that are intended to help disabled seniors live in the community. This article examines how states' generosity in providing HCBS affects the risk of nursing home admission among older Americans and how family availability moderates such effects.

METHODS: We conducted discrete time survival analysis of first long-term (90 or more days) nursing home admissions that occurred between 1995 and 2002, using Health and Retirement Study panel data from respondents born in 1923 or earlier.

RESULT: State HCBS effects were conditional on child availability among older Americans. Living in a state with higher HCBS expenditures was associated with lower risk of nursing home admission among childless seniors (p <.001). However, the association was not statistically significant among seniors with living children. Doubling state HCBS expenditures per person aged 65 or older would reduce the risk of nursing home admission among childless seniors by 35%.

DISCUSSION: Results provided modest but important evidence supportive of increasing state investment in HCBS. Within-state allocation of HCBS resources, however, requires further research and careful consideration about fairness for individual seniors and their families as well as cost effectiveness.

DOI10.1093/geronb/62.3.s169
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/17507592?dopt=Abstract

Endnote Keywords

Home Care Services/Nursing Homes/Health Policy/Elderly

Endnote ID

17370

Alternate JournalJ Gerontol B Psychol Sci Soc Sci
Citation Key7138
PubMed ID17507592
PubMed Central IDPMC2093949
Grant ListR01 AG021648-02 / AG / NIA NIH HHS / United States
R01 AG021648-04 / AG / NIA NIH HHS / United States
R01 AG021648-03 / AG / NIA NIH HHS / United States
R01 AG021648-01A1 / AG / NIA NIH HHS / United States
R01 AG021648 / AG / NIA NIH HHS / United States