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Increasing Prevalence of Assisted Living as a Substitute for Private‐Pay Long‐Term Nursing Care
Author(s) -
Silver Benjamin C.,
Grabowski David C.,
Gozalo Pedro L.,
Dosa David,
Thomas Kali S.
Publication year - 2018
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.13021
Subject(s) - minimum data set , census , nursing homes , long term care , medicine , private sector , demography , demographic economics , nursing , environmental health , economics , economic growth , population , sociology
Objective Given the tremendous growth in assisted living ( AL ) over the past 20 years, it is important to understand how expansion has affected the demand for long‐term care ( LTC ) provided in nursing homes ( NH s). We estimated the effect of a change in county‐level AL beds on the prevalence of private‐pay residents and private‐pay resident days at the NH ‐level. Data Sources National census of large AL providers (25+ beds), and Minimum Data Set combined with Medicare enrollment records and claims from 2007 and 2014. Study Design Retrospective longitudinal analysis of LTC markets. Principal Findings Mean AL beds per county increased from 285 to 324, while NH s exhibited a decrease in private‐pay residents (20.1 to 17.7 percent) and resident days (21.3 to 17.5 percent). An increase of 1,000 AL beds at the county level is associated with a reduction of 0.44 percentage points in private‐pay resident days but is not significantly associated with percent of private‐pay residents. Conclusions These results suggest that increases in AL capacity have potentially allowed NH residents to delay or decrease their privately financed lengths of stay. As demand for AL continues to grow, it will be important to assess the effects on other LTC sectors.