Use of nursing homes by a high-risk long-term care population

Limited information exists concerning lifetime use of nursing home services by the aged. This article examines the longitudinal experience, over four years, of elderly individuals at high risk of institutionalization, and develops a simple model of nursing home use based on these observations. This model allows us to predict future lifetime use under alternative assumptions. The main observations drawn from this sample are that high-risk elderly tend to move from the community to nursing homes, but not back to the community except for short, transitional stays. Further, despite high overall mortality rates, the expected nursing home use by these high-risk elderly is very high, due to long average stays by a minority of the sample that enters a nursing home and remains there longer than six months.