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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Transitions in long-term care
H Temkin-Greener1, M R Meiners
1Community Coalition for Long-Term Care, Rochester, NY 14604, USA.
The Gerontologist
|April 1, 1995
Summary
Recent hospitalizations for stroke, dementia, or hip fractures predict nursing home admissions for Medicaid elderly but not private pay individuals. This highlights differing factors influencing long-term care transitions.
Area of Science:
- Gerontology
- Health Economics
- Public Policy
Background:
- Understanding transitions between community living and nursing homes is crucial for older adults.
- Differentiating factors for private pay versus Medicaid-eligible individuals is essential for targeted policy.
- Long-term care needs and financing significantly impact the elderly population.
Purpose of the Study:
- To examine factors influencing transitions to nursing homes for private pay and Medicaid-eligible older adults.
- To compare the predictors of nursing home admission for these two distinct financial groups.
- To inform long-term care insurance design and public policy.
Main Methods:
- Utilized discrete-time hazard functions to analyze transition probabilities.
- Focused on older adults (65+) transitioning between community and nursing home settings.
- Compared factors associated with nursing home admissions for private pay and Medicaid-eligible populations.
Main Results:
- Recent hospitalizations for stroke, dementia, or hip fractures strongly predicted nursing home admissions for Medicaid-eligible individuals.
- These hospitalizations were not significant predictors for the private pay population, with the exception of dementia.
- Identified distinct risk factors for nursing home transitions based on payer status.
Conclusions:
- Payer status (private pay vs. Medicaid) significantly influences the factors predicting nursing home transitions in older adults.
- Dementia is a consistent predictor across both financial groups, while other conditions like stroke and hip fracture are more specific to the Medicaid population.
- Findings have direct implications for designing effective long-term care insurance and public policy.
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