About the Center
    Physical Activity
    Resources and Bibliography
    Aging Network
    Long Term Care Institute
    Contact Us
    Subscribe to NAN
Risk of nursing home admission among older Americans: does states' spending on home- and community-based services matter?
  OBJECTIVE: . States vary greatly in their support for home- and community-based services (HCBS) that are intended to help disabled seniors live in the community. This article examines how states' generosity in providing HCBS affects the risk of nursing home admission among older Americans and how family availability moderates such effects. Methods. We conducted discrete time survival analysis of first long-term (90 or more days) nursing home admissions that occurred between 1995 and 2002, using Health and Retirement Study panel data from respondents born in 1923 or earlier. RESULT: . State HCBS effects were conditional on child availability among older Americans. Living in a state with higher HCBS expenditures was associated with lower risk of nursing home admission among childless seniors (p <.001). However, the association was not statistically significant among seniors with living children. Doubling state HCBS expenditures per person aged 65 or older would reduce the risk of nursing home admission among childless seniors by 35%. Discussion. Results provided modest but important evidence supportive of increasing state investment in HCBS. Within-state allocation of HCBS resources, however, requires further research and careful consideration about fairness for individual seniors and their families as well as cost effectiveness.
Type Journal - Bibliographic Record
Resource Type
(If applicable)
Author(s) Muramatsu N, Yin H, Campbell RT, Hoyem RL, Jacob MA, Ross CO.
Book Publisher
Journal Publisher J Gerontol B: Psychol Sci Soc Sci
Year 2007
Pages S169-78
Article Title
Edition 62
Contact Information
(If applicable)
(If applicable)
     »  Search Resource Center
       Type Keyword:

National Resource Center on Nutrition, Physical Activity & Aging
| Florida International University, OE 200, Miami, FL 33199
Phone: 305-348-1517 | Fax: 305-348-1518 | E-mail: nutrionandaging@fiu.edu

This website is supported, in part, by a grant from the Administration on Aging, Department of Health and Human
Services (DHHS). Grantees undertaking projects under government sponsorship are encouraged to express freely their
findings and conclusions. Points of view or opinions do not, therefore, reflect official DHHS policy.