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Utilization across the continuum of long-term care services
Evelinn A Borrayo1, Jennifer R Salmon, Larry Polivka
1Department of Psychology, Colorado State University, Fort Collins, 80523, USA. borrayo@lamar.colostate.edu
The Gerontologist
|September 28, 2002
Summary
Consumer need is the primary driver of long-term care (LTC) use, influencing placement in nursing facilities (NFs) or home- and community-based services (HCBS). Enabling factors like Medicaid also affect NF utilization.
Area of Science:
- Gerontology
- Health Services Research
- Sociology
Background:
- Understanding factors influencing long-term care (LTC) utilization is crucial for effective elder care.
- Predisposing, enabling, and need characteristics are key determinants of service selection.
Purpose of the Study:
- To analyze how consumer predisposing, enabling, and need characteristics influence the choice between nursing facilities (NFs), assisted living facilities, or home- and community-based services (HCBS).
Main Methods:
- Cross-sectional study involving a record review of 1,968 consumers aged 60+ receiving formal LTC services.
- Analysis of predisposing, enabling, and need characteristics as predictors of LTC service utilization.
Main Results:
- Consumer need is the strongest predictor of LTC service use, with high need associated with NF or HCBS placement.
- Enabling characteristics, including Medicaid eligibility and geographic region, correlate with increased NF use.
- Predisposing and enabling factors moderate the impact of need on service utilization.
Conclusions:
- While high need often leads to NF placement, severely impaired elders are also receiving care at home.
- Medicaid eligibility increases the likelihood of NF placement, suggesting a need to re-evaluate public financing to better support home-based care.