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Relations among home- and community-based services investment and nursing home rates of use for working-age and older adults: A state-level analysis

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  • Miller, N.A.

Abstract

Objectives: I examined state-level rates of nursing home use for the period from 2000 to 2007. Methods: I used multivariate fixed-effects models to examine associations between state sociodemographic, economic, supply, and programmatic characteristics and rates of use. Results: Nursing home use declined among older adults (aged ≥65 years) in more than two thirds of states and the District of Columbia but increased among older working-age adults (aged 31-64 years) in all but 2 states. State characteristics associated with these trends differed by age group. Although relatively greater state investment in Medicaid home- and community-based services coupled with reduced nursing home capacity was associated with reduced rates of nursing home care for adults aged 65 years and older, neither characteristic was associated with use among older working-age adults. Their use was associated with state sociodemographic characteristics, as well as chronic disease prevalence. Conclusions: Policy efforts to expand home- and community-based services and to reduce nursing facility capacity appear warranted. To more fully extend the Supreme Court's Olmstead decision's promise to older working-age adults, additional efforts to understand factors driving their increasing use are required.

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  • Miller, N.A., 2011. "Relations among home- and community-based services investment and nursing home rates of use for working-age and older adults: A state-level analysis," American Journal of Public Health, American Public Health Association, vol. 101(9), pages 1735-1741.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2011.300163_5
    DOI: 10.2105/AJPH.2011.300163
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    Cited by:

    1. Riitta Turjamaa & Sirpa Hartikainen & Anna‐Maija Pietilä, 2013. "Forgotten resources of older home care clients: Focus group study in Finland," Nursing & Health Sciences, John Wiley & Sons, vol. 15(3), pages 333-339, September.
    2. Liu, Yinan & Zai, Xianhua, 2022. "Does Aging at Home Make Older Adults Healthy: Evidence from Medicaid Home and Community-Based Services," GLO Discussion Paper Series 1079 [rev.], Global Labor Organization (GLO), revised 2022.
    3. Riitta Turjamaa & Sirpa Hartikainen & Mari Kangasniemi & Anna‐Maija Pietilä, 2014. "Living longer at home: a qualitative study of older clients' and practical nurses' perceptions of home care," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(21-22), pages 3206-3217, November.
    4. Liu, Yinan & Zai, Xianhua, 2022. "The Benefits of Medicaid Home and Community-Based Services on Health," GLO Discussion Paper Series 1079, Global Labor Organization (GLO).
    5. Carol V. Irvin & Noelle Denny-Brown & Eric Morris & Claire Postman, "undated". "Pathways to Independence: Transitioning Adults Under Age 65 from Nursing Homes to Community Living," Mathematica Policy Research Reports 4533421b237a4e05ada6cae71, Mathematica Policy Research.
    6. Liu, Yinan & Zai, Xianhua, 2022. "Does Aging at Home Make Older Adults Healthy: Evidence from Medicaid Home and Community-Based Services," EconStor Preprints 249565, ZBW - Leibniz Information Centre for Economics.
    7. Donnelly, Nora-Ann & Humphries, Niamh & Hickey, Anne & Doyle, Frank, 2017. "“We don’t have the infrastructure to support them at home”: How health system inadequacies impact on long-term care admissions of people with dementia," Health Policy, Elsevier, vol. 121(12), pages 1280-1287.

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