Place of Death Among Older Americans

Muramatsu, Naoko; Hoyem, Ruby L; Yin, Hongjun; Campbell, Richard T.

doi:10.1097/mlr.0b013e3181791a79

Cited by 44 publications

(21 citation statements)

References 23 publications

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“…In response to growing budget deficits in many states and strong public demand, the 1999 Olmstead Supreme Court decision required that states expand alternative HCBS programs. Some research during that time period showed that higher HCBS spending was negatively related to the likelihood of nursing home admission (Burr, Mutchler, & Pilcher-Warren, 2002; Muramatsu et al, 2007), to the proportion of residents in nursing homes with low-care needs (Hahn, Thomas, Hyer, Andel, & Meng, 2011; Thomas & Mor, 2013) and positively related to the proportion of people able to die at home (Muramatsu, Hoyem, Yin, & Campbell, 2008). In response, many states adopted initiatives to expand community-based care as an alternative of institutional care.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures

et al. 2015

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Over the past two decades, nursing homes and home health care agencies have been influenced by several Medicare and Medicaid policy changes including the adoption of prospective payment for Medicare-paid postacute care and Medicaid-paid long-term home and community-based care reforms. This article examines how spending growth in these sectors was affected by state certificate-of-need (CON) laws, which were designed to limit the growth of providers and have remained unchanged for several decades. Compared with states without CON laws, Medicare and Medicaid spending in states with CON laws grew faster for nursing home care and more slowly for home health care. In particular, we observed the slowest growth in community-based care in states with CON for both the nursing home and home health industries. Thus, controlling for other factors, public postacute and long-term care expenditures in CON states have become dominated by nursing homes.

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Section: Introductionmentioning

confidence: 99%

The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures

et al. 2015

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“…1,2 However, despite these preferences and better outcomes for care at home compared to other settings, in 2007, only 30% of decedents under age 65 and 24% of decedents 65 or older died at home. 3-6 Even when patients want to die at home, lack of caregiver support, 7 lack of healthcare provider knowledge of preferences, 1 and poor symptom control 8 may result in transfer to sub-acute or acute care settings prior to death. 9,10 …”

Section: Introductionmentioning

confidence: 99%

“…For example, compared to wealthier patients, those with lower incomes are less likely to die at home 7,8 due to poorer access to healthcare, less knowledge of resources, less communication with providers about care preferences, lack of resources to assist with caregiving, and greater symptom burden at the end of life. 3,11,12 Additionally, those with lower incomes are less likely to enroll in hospice, which facilitates dying at home. 13,14 In 2003, approximately 50% of hospice enrollees died at home compared to 25% in the general population.…”

Section: Introductionmentioning

confidence: 99%

Association of Hospice Patients' Income and Care Level With Place of Death

Barclay¹,

Kuchibhatla²,

Tulsky³

et al. 2013

JAMA Intern Med

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“…The large inter-state variation remains today. Living in a state supportive of HCBS lowers the risk for nursing home admission among seniors (Muramatsu, Hoyem, Yin, & Campbell, 2008; Muramatsu, Yin, Campbell, Hoyem, Jacob, & Ross, 2007). However, whether state HCBS support affects older adults' psychological well-being is virtually unknown.…”

Section: Introductionmentioning

confidence: 99%

Functional declines, social support, and mental health in the elderly: Does living in a state supportive of home and community-based services make a difference?

Muramatsu

Yin

Hedeker

2010

Social Science & Medicine

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126

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This study examines how acute and chronic stresses associated with functional declines in seniors and their spouses are moderated by their informal and formal support contexts. In the United States, states vary greatly in their support for home and community-based services (HCBS) for seniors with disabilities. This state-to-state variation allowed us to examine mental health effects of living in a society supportive of HCBS for the oldest old, who are at high risk for low or declining functions in daily activities and cognitive abilities. Using a ten-year panel study of a nationally representative sample of the oldest old (>=70 years old) covering the period 1993 to 2002, we conducted mixed-effects logistic regression analysis to incorporate time-varying characteristics of persons and states. As expected, low and declining functions in daily living and cognition constituted significant stressors among seniors and their spouse. Results demonstrated the important role of informal support available from non-spouse family/friends in lowering depression. Living in a state supportive of HCBS was associated with lower depression among seniors experiencing consistently low levels of function or recent functional declines, especially among those without informal support. Our findings were consistent with moderating or buffering models of formal support, suggesting that state HCBS support is effective mainly under conditions of high levels of stressors. Political will is needed to prepare US society to collectively support community-based long-term needs, given the difficulty of preparing ourselves fully for common, but often unexpected, functional declines in later life.

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Place of Death Among Older Americans

Abstract: Background-The majority of Americans die in institutions although most prefer to die at home. States vary greatly in their proportion of home deaths. Although individuals' circumstances largely determine where they die, health policies may affect the range of options available to them.

Cited by 44 publications

References 23 publications

The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures

The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures

Association of Hospice Patients' Income and Care Level With Place of Death

Functional declines, social support, and mental health in the elderly: Does living in a state supportive of home and community-based services make a difference?

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