Risk Factors for Nursing Home Admissions and Exits: A Discrete-time Hazard Function Approach

Abstract

Discrete-time hazard functions were estimated to determine factors associated with the probability of admission to a nursing home from the community, and the probability of discharge to the community from nursing home care, for 3,332 individuals enrolled in The National Long Term Care Channelling Demonstration. This was a relatively frail elderly population assessed to be at high risk for nursing home use. In predicting admissions, major factors were found to be ethnicity (Blacks and Hispanics were at much lower risk), homeownership, advancing age, living alone, exhibiting higher cognitive and functional impairment levels, physician use, and living in an area with a larger nursing home bed supply. The probability of being discharged alive was predicted by several factors, including ethnicity (Blacks being less likely to be discharged), homeownership, being of younger age, better (self-rated) health, functional and cognitive capacities, and medical acuity.

Health Among the Elderly in Germany. New Evidence on Disease, Disability and Care Need

“…The findings on the later are, however, contradictory. A number of studies show an inverse relationship between income and entry into nursing homes (Nihtilä and Martikainen 2007;Himes et al 2000), while other studies do not illustrate any significant association (Tomiak et al 2000;Greene and Ondrich 1990).…”

“…Existing research on long-term care conducted worldwide has mainly focused on those factors influencing the transition to (or exit from) nursing homes (Greene and Ondrich 1990;Wolinsky et al 1992;Tomiak et al 2000). In addition to age, specific medical conditions play an influential role on the decision to use these facilities (Tomiak et al 2000;Greene and Ondrich 1990).…”

“…In addition to age, specific medical conditions play an influential role on the decision to use these facilities (Tomiak et al 2000;Greene and Ondrich 1990). The existing evidence also suggests an impact by marital status, living arrangements, and a number of socioeconomic factors.…”

“…Previous research has generated a number of controversial findings regarding the impact of education on the use of care, but it uses the risk of institutionalization as the proxy rather than receipt of SLTC benefits which is considered in this paper. Some studies demonstrate that it is associated with the risk of the transition to care (Nihtilä 2005;Mustard et al 1999), while others show no effect at all (Greene and Ondrich 1990;Wolinsky et al 1992;Kempen and Suurmeijer 1991;Cai et al 2009), or that there is only an effect for men (Nihtilä and Martikainen 2007) or for women (Tomiak et al 2000).…”

When caregivers are in need of care: African-American caregivers' preferences for their own later life care

“…These experiences coupled with traditional cultural values that have placed the family, especially children and elders, at the center of care has resulted in the cultural precept to "care for your own" (Wimberly, 1997). This ethic of care and the precept to "care for your own" is often invoked to explain the historical underutilization of nursing home services by African Americans (Greene & Ondrich, 1990;Steinbach, 1992;Wolinsky, Callahan, Fitzgerald, & Johnson, 1992) and the continued gap in the use of hospice services (Crawley, Payne, Bolden, Payne, Washington, & Williams, 2000).…”