Determining Predictors of Nursing Home Admission and Sub-Populations of Skilled Nursing Facility Residents Using the Medicare Current Beneficiary Survey (MCBS)

Title	Determining Predictors of Nursing Home Admission and Sub-Populations of Skilled Nursing Facility Residents Using the Medicare Current Beneficiary Survey (MCBS)
Author	Perron, Rebecca Lyn
Advisors	Orwig, Denise
Program	Gerontology
UMBC Department	Gerontology
Document Type	dissertation
Sponsors	University of Maryland, Baltimore County (UMBC)
Keywords	Gerontology (0351); Sociology, Public and Social Welfare (0630); nursing homes; Medicare; Medicaid; Skilled Nursing Facility; aging
Date Issued	2008-08-21; *
Abstract	ABSTRACT Title of Dissertation: Determining Predictors of Nursing Home Admission and Sub-Populations of Skilled Nursing Facility Residents Using the Medicare Current Beneficiary Survey (MCBS) Name of Candidate: Rebecca L Perron, MPH Doctor of Philosophy, 2008 Dissertation Directed by: Denise Orwig, PhD Assistant Professor University of Maryland School of Medicine Department of Epidemiology & Preventive Medicine BACKGROUND: Nursing home care in the US accounts for a large percentage of Medicare and Medicaid budgets. The Balanced Budget Act of 1997 (BBA'97) mandated a prospective payment system (PPS) for skilled nursing facility stays, potentially leading to changes in the nursing home population. Not only are nursing home stays expensive, but outcomes are consistently poor. OBJECTIVES: (1) Determine predictors for a new nursing home admission post BBA '97; (2) Compare the predictors between skilled nursing facility (SNF) and long-stay residents; and (3) Determine if sub-populations of SNF residents exist. METHODS: This study utilized data from the Medicare Current Beneficiary Survey (MCBS) from 1999 to 2003, by developing three completed cohorts of data. Respondents had to be community-dwelling at their first interview, Medicare- eligible by age, and not in a Medicare Advantage plan, thus the final sample consisted of 8,589 beneficiaries. All analyses explored the relationship between demographic, health status, health care utilization, and environmental variables with overall admissions, admission type, and SNF sub-groups. Bivariate relationships were explored using t-tests, chi-square tests and ANOVAs. All bivariate and multivariate analyses were performed using logistic regression; dichotomous for Aims 1 and 2 and multinomial for Aim 3. RESULTS: 12.6% of the initial sample had a nursing home admission. Across the three aims of the study, the only significant socioeconomic variable was ethnicity. Mobility impairments were consistently significant. Dementia was also a consistent predictor of nursing home admission and differed between SNF groups. Health care utilization was significant, particularly drug utilization, which decreased risk for overall admission and was more predictive of SNF admissions. Home modifications increased risk of nursing home entry but did not affect type of admission. CONCLUSIONS: Results showed that BBA '97 did not vastly change the predictors of nursing home admission but may have affected the SNF sub populations, with two distinct sub-groups identified. More research is needed on the impact of home modifications, as well as research exploring the effect of Medicare Part D drug benefit on nursing home admission.
Identifier	1203
Format	application:pdf
Language	en
Collection	UMBC Theses and Dissertations
Rights Statement	This item may be protected under Title 17 of the U.S. Copyright Law. It is made available by UMBC for non-commercial research and education. For permission to publish or reproduce, please see http://aok.lib.umbc.edu/specoll/repro.php or contact Special Collections at speccoll(at)umbc.edu.
Source	umi-umbc-1203.pdf

Add tags for Determining Predictors of Nursing Home Admission and Sub-Populations of Skilled Nursing Facility Residents Using the Medicare Current Beneficiary Survey (MCBS)

View as list | View as tag cloud | report abuse

Post a Comment for Determining Predictors of Nursing Home Admission and Sub-Populations of Skilled Nursing Facility Residents Using the Medicare Current Beneficiary Survey (MCBS)

Find results with:

Searching collections:

Home Determining Predictors of Nursing Home Admission and Sub-Populations of Skilled Nursing Facility...

Determining Predictors of Nursing Home Admission and Sub-Populations of Skilled Nursing Facility Residents Using the Medicare Current Beneficiary Survey (MCBS)

Description

Tags

Comments