Dataset Information

Changes in Long-Term Care Markets: Assisted Living Supply and the Prevalence of Low-Care Residents in Nursing Homes.

ABSTRACT:

Objectives

To assess the effect of changes in assisted living (AL) capacity within a market on prevalence of residents with low care needs in nursing homes.

Design

Retrospective, longitudinal analysis of nursing home markets.

Setting and participants

Twelve thousand two hundred fifity-one nursing homes in operation during 2007 and 2014.

Measurements

We analyzed the percentage of residents in a nursing home who qualified as low-care. For each nursing home, we constructed a market consisting of AL communities, Medicare beneficiaries, and competing nursing homes within a 15-mile radius. We estimated the effect of change in AL beds on prevalence of low-care residents using multivariate linear models with year and nursing home fixed effects.

Results

The supply of AL beds increased by an average 258 beds per nursing home market (standard deviation = 591) during the study period. The prevalence of low-care residents decreased from an average of 13.0% (median 10.5%) to 12.2% (median 9.5%). In adjusted models, a 100-bed increase in AL supply was associated with a decrease in low-care residents of 0.041 percentage points (P = .026), controlling for changes in market and nursing home characteristics, county demographics, and year and nursing home fixed effects. In markets with a high percentage of its Medicare beneficiaries (≥14%) dual eligible for Medicaid, the effect of AL is stronger, with a 0.066-percentage point decrease per 100 AL beds (P = .026) vs a 0.016-percentage point decrease in low-duals markets (P = .48).

Conclusions and implications

Our analysis suggests that some of the growth in AL capacity serves as a substitute for nursing homes for patients with low care needs. Furthermore, the effects are concentrated in markets with an above-average proportion of beneficiaries with dual Medicaid eligibility.

SUBMITTER: Cornell PY

PROVIDER: S-EPMC7396306 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Changes in Long-Term Care Markets: Assisted Living Supply and the Prevalence of Low-Care Residents in Nursing Homes.

Cornell Portia Y PY Zhang Wenhan W Thomas Kali S KS

Journal of the American Medical Directors Association 20200227 8

<h4>Objectives</h4>To assess the effect of changes in assisted living (AL) capacity within a market on prevalence of residents with low care needs in nursing homes.<h4>Design</h4>Retrospective, longitudinal analysis of nursing home markets.<h4>Setting and participants</h4>Twelve thousand two hundred fifity-one nursing homes in operation during 2007 and 2014.<h4>Measurements</h4>We analyzed the percentage of residents in a nursing home who qualified as low-care. For each nursing home, we construc ...[more]

PMID: 32113912

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Dataset Information

Changes in Long-Term Care Markets: Assisted Living Supply and the Prevalence of Low-Care Residents in Nursing Homes.

Objectives

Design

Setting and participants

Measurements

Results

Conclusions and implications

Publications

Changes in Long-Term Care Markets: Assisted Living Supply and the Prevalence of Low-Care Residents in Nursing Homes.

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