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Contextual determinants of US nursing home racial/ethnic diversity

Author

Listed:
  • Davis, Jullet A.
  • Weech-Maldonado, Robert
  • Lapane, Kate L.
  • Laberge, Alex

Abstract

We hypothesized that for-profit/chain affiliated nursing homes, those in states with higher Medicaid reimbursement, and those in more competitive markets would have greater resident racial/ethnic diversity than nursing homes not meeting these criteria. Using 2004 Online Survey, Certification and Reporting data, Minimum Data Set, Lewis Mumford Center for Comparative Urban and Regional Research data, and the Area Resource File, we included U.S. Medicare/Medicaid certified nursing homes (N = 8950) located in 310 Metropolitan Statistical Areas. The dependent variable quantified facility-level multiracial diversity. Ordinary least squares regression showed support for the hypothesized relationships: for-profit/chain affiliated nursing homes were more diverse than nursing homes in all other ownership/chain member categories, while higher Medicaid per-diem rates, greater residential diversity, and stronger market competition were also positively associated with nursing home racial/ethnic composition. Results suggest there is room for policy changes to achieve equitable access to all levels of nursing home services for minority elders.

Suggested Citation

  • Davis, Jullet A. & Weech-Maldonado, Robert & Lapane, Kate L. & Laberge, Alex, 2014. "Contextual determinants of US nursing home racial/ethnic diversity," Social Science & Medicine, Elsevier, vol. 104(C), pages 142-147.
  • Handle: RePEc:eee:socmed:v:104:y:2014:i:c:p:142-147
    DOI: 10.1016/j.socscimed.2013.12.009
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    References listed on IDEAS

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    1. Kris Knox & Eric Blankmeyer & J. Stutzman, 2006. "Private-Pay Demand for Nursing Facilities in a Market with Excess Capacity," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 34(1), pages 75-83, March.
    2. Rajiv Sethi & Rohini Somanathan, 2009. "Racial Inequality and Segregation Measures: Some Evidence from the 2000 Census," The Review of Black Political Economy, Springer;National Economic Association, vol. 36(2), pages 79-91, June.
    3. White, Halbert, 1980. "A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity," Econometrica, Econometric Society, vol. 48(4), pages 817-838, May.
    4. David C. Grabowski, 2004. "A Longitudinal Study of Medicaid Payment, Private-Pay Price and Nursing Home Quality," International Journal of Health Economics and Management, Springer, vol. 4(1), pages 5-26, March.
    5. Zinn, Jacqueline & Mor, Vincent & Feng, Zhanlian & Intrator, Orna, 2009. "Determinants of performance failure in the nursing home industry," Social Science & Medicine, Elsevier, vol. 68(5), pages 933-940, March.
    6. Sean Reardon & John Yun & Tamela Eitle, 2000. "The changing structure of school segregation: Measurement and evidence of multiracial metropolitan-area school segregation, 1989–1995," Demography, Springer;Population Association of America (PAA), vol. 37(3), pages 351-364, August.
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