A Profile of Black and Latino Older Adults Receiving Care in Nursing Homes: 2011–2017 |
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| Institution: | 1. Rory Meyers College of Nursing, New York University, New York, NY, USA;2. Rand Corporation, Boston, MA, USA;3. Harvard Medical School, Boston, MA, USA;4. University of Connecticut Health Center, Farmington, CT, USA;5. Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA;6. Columbia University School of Nursing, New York, NY, USA;1. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;2. Schools of Social Work and Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;3. Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;4. University of North Texas Health Science Center, Fort Worth, TX, USA;1. Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia;2. Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands;3. Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore;4. Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore;1. Department of Occupational Therapy, University of Texas Medical Branch, Galveston, TX, USA;2. Department of Clinical Research and Leadership, The George Washington University, Washington, DC, USA;3. Office of Biostatistics, Department of Preventive Medicine and Public Health, University of Texas Medical Branch, Galveston, TX, USA;4. Department of Occupational Therapy, Colorado State University, Fort Collins, CO, USA;5. Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA;6. Department of Nutrition, Metabolism and Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA;1. Penn Center for Mental Health, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA;2. Department of Health Care Management, The Wharton School, University of Pennsylvania, Philadelphia, PA, USA;3. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA;4. Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA;5. Icahn School of Medicine at Mount Sinai, New York, NY, USA;6. Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA;7. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA |
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| Abstract: | ObjectiveTo identify if disparate trends in the access and use of nursing home (NH) services among Black and Latino older adults compared with White older adults persist. Access was operationalized as the NHs that served Black, Latino, and White residents. Use was operationalized as the utilization of NH services by Black, Latino, and White residents.DesignThis was an observational study analyzing facility-level data from LTCfocus for 2011 to 2017.Setting and ParticipantsAll NH residents present in US NHs participating in the Centers for Medicare and Medicaid Services program on the first Thursday in April in the years 2011 to 2017. NHs with fewer than 4500 bed-days per year are excluded in the LCTfocus dataset. Black, Latino, and White were the racial/ethnic groups of interest.MethodsWe calculated the mean percentage of each racial/ethnic group in NHs (Black, Latino, White) annually along with the number of NHs that provided care for these groups. We conducted a simple trend analysis using ordinary least squares to estimate the change in NH access and use by racial/ethnic group over time.ResultsOur NH sample ranged from 15,564 in 2011 to 14,956 in 2017. Latino residents' use of NHs increased by 20.47% and Black residents increased by 11.42%, whereas there was a 1.36% decrease in White residents’ use of NHs. In this 7-year span, there was a 4.44% and 6.41% decline in the number of NHs that serve any Black and Latino older adults, respectively, compared with a 2.26% decline in NHs that serve only White older adults (access).Conclusions and ImplicationsOur findings reveal a continued disproportionate rise in Black and Latino older adults’ use of NHs while the number of NHs that serve this population have declined. This work can inform federal and state policies to ensure access to long-term care services and supports in the community for all older adults and prevent inappropriate NH closures. |
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| Keywords: | Long-term care access to care health care disparities |
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