An analysis of the heterogeneity of U.S. nursing home patients

Research has shown that the nursing home patient population is quite heterogeneous in terms of both individual patient characteristics and service needs. Furthermore, existing administrative classifications do a poor job of representing this heterogeneity. As a consequence we have conducted an analysis of the individual and service characteristics of two types of patients represented in the National Nursing Home Survey of 1977 (i.e., patients whose primary source of payment was Medicare and patients whose primary payment source was not Medicare). In this analysis we identified patterns of individual characteristics within the two patient groups and showed how these patterns related to their service needs. The logic of the model permitted us both to establish patterns of characteristics within the two payment types and to examine the implications of individual heterogeneity remaining in the classification. This makes the methodology useful both as a research tool for understanding the nature of the nursing home population and as a tool for studying the consequences of various classification schemes for questions of identifying service patterns and needs as well as the evaluation of policy options.