State commitment to home and community-based services: effects on independent living for older unmarried women

J Aging Soc Policy. 2005;17(1):1-18. doi: 10.1300/J031v17n01_01.

Abstract

This study examines the impact of state variation in commitment to the provision of home and community-based services on the living arrangement outcomes of older unmarried females with functionallimitations. We combine data from the 1990 U.S. Census of Population (PUMS) with state-level information on long-term care home and community- based service expenditures, nursing home bed availability, and Medicaid nursing home costs from a special report that compares state variation in long-term care systems. Using multilevel logistic regression modeling techniques, we find that the risk of institutionalization compared to community living arrangements is reduced as spending for home and community-based services at the state level increases. We discuss these findings in light of policy changes during the 1990s.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Community Health Services / economics*
  • Community Health Services / statistics & numerical data
  • Disabled Persons
  • Female
  • Financing, Government / organization & administration*
  • Frail Elderly
  • Health Services for the Aged / economics*
  • Health Services for the Aged / statistics & numerical data
  • Home Care Services / economics
  • Home Care Services / statistics & numerical data
  • Humans
  • Institutionalization*
  • Logistic Models
  • Long-Term Care / economics
  • Long-Term Care / statistics & numerical data
  • Medicaid
  • Middle Aged
  • Nursing Homes / statistics & numerical data
  • Residence Characteristics
  • Single Person
  • Socioeconomic Factors
  • State Government