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Predicting Nursing Home Utilization Among the High-Risk Elderly


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  • Alan M. Garber
  • Thomas E. MaCurdy
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    This paper explores the influence of various characteristics on nursing home utilization. It examines a targeted population of elderly individuals whose poor health and lack of social supports were expected to lead to heavy use of long-term care. We develop an empirical framework based on a transition probability model to describe the frequency and duration of nursing home admissions. Using longitudinal data on the high-risk elderly enrollees of the National Long-Term Care Demonstration ("Channeling" demonstration), we. find that a small set of characteristics distinguish individuals who are likely to be heavy utilizers of nursing homes from low utilizers. The factors associated with a high likelihood of institutionalization are not identical to the health characteristics associated with high mortality; for example, the likelihood of death increases with age, but nursing home utilization does not, when functional status and other characteristics are held constant. A somewhat healthier population might have used nursing homes more heavily than the Channeling participants, whose nursing home utilization was limited by high mortality.

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    Bibliographic Info

    Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 2843.

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    Date of creation: Feb 1989
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    Publication status: published as Issues in the Economics of Aging, ed. David A. Wise, University of Chicago Press, 1990, pp. 173-200
    Handle: RePEc:nbr:nberwo:2843

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    Cited by:
    1. Jonathan S. Feinstein, 1993. "Elderly Health, Housing, and Mobility," NBER Working Papers 4572, National Bureau of Economic Research, Inc.
    2. Axel Borsch-Supan, 1989. "A Dynamic Analysis of Household Dissolution and Living Arrangement Transitions by Elderly Americans," NBER Working Papers 2808, National Bureau of Economic Research, Inc.
    3. VanderHart, Peter G., 1998. "The Housing Decisions of Older Households: A Dynamic Analysis," Journal of Housing Economics, Elsevier, Elsevier, vol. 7(1), pages 21-48, March.
    4. David M. Cutler & Louise M. Sheiner, 1993. "Policy Options for Long-Term Care," NBER Working Papers 4302, National Bureau of Economic Research, Inc.


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