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Related Experiment Videos

Getting by in the community: lessons from frail elders.

Sharon K Long1, Korbin Liu, Kirsten Black

  • 1The Urban Institute, 2100 M Street, NW, Washington, DC, 20037, USA. Slong@ui.urban.org

Journal of Aging & Social Policy
|March 12, 2005
PubMed
Summary

Elderly individuals needing care often rely on informal support or forgo services to stay in the community without Medicaid home and community-based care (HCBC). This can lead to increased nursing home use.

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Area of Science:

  • Gerontology
  • Health Services Research
  • Public Health Policy

Background:

  • Many functionally impaired elderly individuals aim to age in place within their communities.
  • Access to and utilization of formal home and community-based care (HCBC) services, particularly under programs like Medicaid, is crucial for enabling community dwelling.
  • Understanding the care strategies of those who forgo formal HCBC is essential for effective elder care policy.

Purpose of the Study:

  • To investigate the methods functionally impaired elderly individuals use to remain in the community without formal home- and community- based care (HCBC) services funded by Medicaid.
  • To compare the subsequent health outcomes, specifically nursing home entry, between HCBC non-participants and participants.

Main Methods:

  • Analysis of administrative data from HCBC programs and Medicare.

Related Experiment Videos

  • Integration of survey data from functionally impaired elderly individuals.
  • Comparative analysis of nursing home entry rates between HCBC participants and non-participants.

    • Main Results:

    • Non-participants in HCBC often rely on informal care networks, Medicare-provided home care, or unmet service needs.
    • Individuals not utilizing HCBC services were significantly more likely to enter a nursing home within six months post-assessment compared to participants.
    • The findings suggest potential short-term Medicaid cost savings from non-participation may be offset by increased long-term nursing home expenditures.

    Conclusions:

    • Functionally impaired elderly individuals can remain in the community without formal HCBC by utilizing informal support and Medicare services, or by foregoing needed care.
    • Non-participation in HCBC is associated with a higher likelihood of nursing home placement, raising concerns about long-term care costs.
    • Further research is needed to definitively link HCBC non-participation to increased nursing home entry and to evaluate the long-term economic implications for Medicaid.