The Substitutability of Adult Foster Care for Nursing Home Care in Oregon

Nyman, John A.; Finch, Michael; Kane, Rosalie A.; Kane, Robert L; Illston, Laurel Hixon

doi:10.1097/00005650-199708000-00006

Cited by 14 publications

(12 citation statements)

References 11 publications

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“…With the exception of one previous study finding that the growth in adult foster care services in Oregon was related to a reduction in the number of nursing home residents (Nyman et al. ), we are not aware of any studies addressing this important policy issue. To address this gap in the literature, we examine this issue using data from 13 states, accounting for nearly 20 percent of the elderly (85+) U.S. population.…”

Section: Introductionmentioning

confidence: 92%

Assisted Living Expansion and the Market for Nursing Home Care

Grabowski

Stevenson

Cornell

2012

Health Services Research

106

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Section: Introductionmentioning

confidence: 92%

Assisted Living Expansion and the Market for Nursing Home Care

Grabowski

Stevenson

Cornell

2012

Health Services Research

106

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“…Although there is some possibility of substitution from informal (Van Houtven and Norton, 2004) and formal (Nyman et al, 1997) care sources, nursing homes are the destination of last resort for many individuals, implying that demand is quite inelastic. Individuals generally prefer long-term care in the least restrictive setting possible (Kane and Kane, 2001), and the empirical evidence is suggestive of greater demand responsiveness among nursing home substitutes such as home health care (Lee et al, 1999) or community-based services (Weissert et al, 1988).…”

Section: Moral Hazard and Nursing Home Utilization: Conceptual Frameworkmentioning

confidence: 99%

Moral hazard in nursing home use

Grabowski

Gruber

2007

Journal of Health Economics

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Nursing home expenditures are a rapidly growing share of national health care spending with the government functioning as the dominant payer of services. Public insurance for nursing home care is tightly targeted on income and assets, which imposes a major tax on savings; moreover, low state reimbursement for Medicaid patients has been shown to lower treatment quality, and bed supply constraints may deny access to needy individuals. However, expanding eligibility, increasing Medicaid reimbursement, or allowing more nursing home bed slots has the potential to induce more nursing home use, increasing the social costs of long-term care. A problem in evaluating this tradeoff is that we know remarkably little about the effects of government policy on nursing home utilization. We attempt to address this shortcoming using multiple waves of the National Long-Term Care Survey, matched to changing state Medicaid rules for nursing home care. We find consistent evidence of no effect of Medicaid policies on nursing home utilization, suggesting that demand for nursing home care is relatively inelastic with respect to public program generosity. From a policy perspective, this finding indicates that changes in overall Medicaid generosity will not have large effects on utilization.

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“…But the small scale of foster care suits rural areas. Some evidence has suggested that people with dementia do well in these small, familiar settings, and they sometimes relocate to foster care from AL as their dementia worsens (Kane, Kane, Illston, Nyman, & Finch, 1991;Nyman, Finch, Kane, Kane, & Illston, 1997;Stark, Kane, Kane, & Finch, 1995).…”

mentioning

confidence: 99%

Assisted Living Literature Through May 2004: Taking Stock

Kane¹,

Chan²,

Kane³

2007

The Gerontologist

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Purpose: This article assesses the state of research on assisted living (AL) from 1989 to May 2004. Design and Methods: We undertook keyword searches for AL research and amplified these with searches of Web sites, conference proceedings, and follow-up inquiries. We annotated and coded the resultant items according to categories reflecting the research methods used and the topics studied. We did additional comparisons for 38 studies with quantitative data that permitted summarizing resident characteristics, settings, and entry and move-out patterns. Results: The 411 identified items ranged across a large number of topics. Qualitative studies outnumbered quantitative ones, and longitudinal studies were rare. We found little standardization in the way variables were measured, making cross-study comparisons difficult. As AL research has become more common, some items are directed at studying ways to proceed within AL as opposed to globally commenting on the worth of AL as a service sector. Implications: The research base for AL has grown rapidly but is still underdeveloped. We recommend using more consistent sets of standardized measures in AL studies and reporting analyses based on them. We also recommend fuller reporting of details on sampling, time frames, and measures in AL research.

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The Substitutability of Adult Foster Care for Nursing Home Care in Oregon

Cited by 14 publications

References 11 publications

Assisted Living Expansion and the Market for Nursing Home Care

Assisted Living Expansion and the Market for Nursing Home Care

Moral hazard in nursing home use

Assisted Living Literature Through May 2004: Taking Stock

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