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Predicting Nursing Home Utilization Among the High-Risk Elderly


  • Alan M. Garber
  • Thomas E. MaCurdy


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.

Suggested Citation

  • Alan M. Garber & Thomas E. MaCurdy, 1989. "Predicting Nursing Home Utilization Among the High-Risk Elderly," NBER Working Papers 2843, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:2843
    Note: AG HE

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    Cited by:

    1. VanderHart, Peter G., 1998. "The Housing Decisions of Older Households: A Dynamic Analysis," Journal of Housing Economics, Elsevier, vol. 7(1), pages 21-48, March.
    2. David M. Cutler & Louise Sheiner, 1994. "Policy Options for Long-Term Care," NBER Chapters, in: Studies in the Economics of Aging, pages 395-442, National Bureau of Economic Research, Inc.
    3. Jonathan Feinstein, 1996. "Elderly Health, Housing, and Mobility," NBER Chapters, in: Advances in the Economics of Aging, pages 275-320, National Bureau of Economic Research, Inc.
    4. Peter G. VanderHart, 1994. "An Empirical Analysis of the Housing Decisions of Older Homeowners," Real Estate Economics, American Real Estate and Urban Economics Association, vol. 22(2), pages 205-233, June.
    5. Alan M. Garber, 1994. "Financing Health Care for Elderly Americans in the 1990s," NBER Chapters, in: Aging in the United States and Japan: Economic Trends, pages 175-194, National Bureau of Economic Research, Inc.
    6. 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.

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