Increasing Prevalence of Assisted Living as a Substitute for Private‐Pay Long‐Term Nursing Care

Objective Given the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for long‐term care (LTC) provided in nursing homes (NHs). We estimated the effect of a change in county‐level AL beds on the prevalence of private...

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Vydáno v:Health services research Ročník 53; číslo 6; s. 4906 - 4920
Hlavní autoři: Silver, Benjamin C., Grabowski, David C., Gozalo, Pedro L., Dosa, David, Thomas, Kali S.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Health Research and Educational Trust 01.12.2018
Blackwell Publishing Ltd
John Wiley and Sons Inc
Témata:
Aged
Aged, 80 and over
Analysis
Assisted living
Assisted living facilities
Assisted Living Facilities - statistics & numerical data
Censuses
Counties
Enrollments
Health Expenditures - statistics & numerical data
Health services
Humans
Insurance Claim Review
Length of residency
Long term care
Long term health care
Long-term care of the sick
Markets
Medicaid - economics
Medicare
Medicare - economics
Medicare - statistics & numerical data
nursing home
Nursing homes
Nursing Homes - statistics & numerical data
Prevalence
Residents
Retrospective Studies
Services
Skilled Nursing Care, Quality, and Cost
Studies
United States
United States
New Hampshire
nursing home
long-term care
Assisted living
ISSN:0017-9124, 1475-6773, 1475-6773
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Shrnutí:Objective Given the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for long‐term care (LTC) provided in nursing homes (NHs). We estimated the effect of a change in county‐level AL beds on the prevalence of private‐pay residents and private‐pay resident days at the NH‐level. Data Sources National census of large AL providers (25+ beds), and Minimum Data Set combined with Medicare enrollment records and claims from 2007 and 2014. Study Design Retrospective longitudinal analysis of LTC markets. Principal Findings Mean AL beds per county increased from 285 to 324, while NHs exhibited a decrease in private‐pay residents (20.1 to 17.7 percent) and resident days (21.3 to 17.5 percent). An increase of 1,000 AL beds at the county level is associated with a reduction of 0.44 percentage points in private‐pay resident days but is not significantly associated with percent of private‐pay residents. Conclusions These results suggest that increases in AL capacity have potentially allowed NH residents to delay or decrease their privately financed lengths of stay. As demand for AL continues to grow, it will be important to assess the effects on other LTC sectors.
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Correction added on 20 August 2018, after first online publication: the corresponding author of this article has been changed to “Kali S. Thomas”.
ISSN:0017-9124
1475-6773
1475-6773
DOI:10.1111/1475-6773.13021