Differences between newly admitted nursing home residents in rural and nonrural areas in a national sample.
ABSTRACT Previous research in specific locales indicates that individuals admitted to rural nursing homes have lower care needs than individuals admitted to nursing homes in urban areas, and that rural nursing homes differ in their mix of short-stay and chronic-care residents. This research investigates whether differences in acuity are a function of differences in resident payer status and occur for both individuals admitted for short stays, with Medicare as payer, and those needing chronic care.
We used a representative 10% sample of national resident assessments (Minimum Data Set) for calendar year 2000 (N = 197,589). We conducted statistical analyses (means, percentages, and logistic regression) to investigate differences in Medicare and non-Medicare admissions to facilities in metropolitan and nonmetropolitan areas.
Non-Medicare residents admitted to rural nursing facilities have lower acuity scores than non-Medicare residents admitted to metropolitan nursing homes. However, individuals admitted under Medicare were similar in rural and urban areas.
Differences in resident acuity at admission among facilities in different locales were largely a function of lower acuity levels for individuals admitted to rural nursing homes for long-term or chronic care, although differences in Medicare census also played some role in facility-level differences in acuity. Other factors must be explored to determine why this lower acuity occurs and whether higher use of rural nursing homes by less impaired older persons meets their needs and preferences and represents good public policy.
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ABSTRACT: Objectives: Across the developed world, wait lists for facility-based long-term care (LTC) beds continue to grow. Wait lists are primarily driven by the needs of aging populations (demand-side factors). Less attention has been given to system capacity to provide community alternatives to LTC (supply-side factors). We examine the role of both demand- and supply-side factors by comparing the characteristics of individuals who have been assessed and deemed eligible for LTC in urban and rural/underserviced parts of northwestern Ontario, Canada. Methods: Home care assessment data were analyzed for all individuals waiting for LTC in northwestern Ontario as of March 2008 (n=858). For the analysis, the sample was separated into urban and rural groups to account for geographical differences in wait list location. Characteristics between these two groups were compared. Results: Individuals on LTC wait lists in the rural areas were significantly less impaired in activities of daily living and cognition than their counterparts in the urban area. However, in both areas, impairments in lighter-care activities appeared to be a key wait list driver, and few people had an informal caregiver living in the home. Conclusions: Our data suggest that LTC wait lists reflect, at least to some extent, insufficient community capacity, not just need for LTC.Healthcare policy = Politiques de sante 08/2012; 8(1):92-105. DOI:10.12927/hcpol.2012.23023
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ABSTRACT: In this study,we investigated how many nursing home residents receive physiotherapy and which factors relate to the provision of treatment. Data were collected from a random sample of 600 residents admitted for rehabilitation or long-term care, through interviews with nursing home physicians and physiotherapists. On average 69% of the residents received PT, however, this percentage differed significantly across nursing homes. Especially the number of physiotherapists available explained this difference. Residents admitted to a somatic ward for rehabilitation were most likely to receive physiotherapy. This suggests a potential under-use of PT for long-term residents with cognitive problems. (aut. ref.)
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ABSTRACT: This study investigates differences in social support and nursing home admission by rurality of residence. We use discrete-time event history models with longitudinal data from seven waves (1998-2010) of the Health and Retirement Study to prospectively examine the risk of spending 30 or more days in a nursing home (n = 5,913). Results show that elders with a health problem who live in rural areas of the South or Midwest have approximately 2 times higher odds of nursing home entry than elders living in urban areas in the Northeast. Rural elders report somewhat higher social support than non-rural elders, and controlling for these forms of social support does not explain the higher risk of a nursing home stay for Southerners and Midwesterners living in rural areas. Results suggest that social support has a similar association with nursing home entry for rural, suburban, and urban elders. © The Author(s) 2015.Journal of Applied Gerontology 01/2015; DOI:10.1177/0733464814566677 · 0.97 Impact Factor