A State-Level Examination of the Association Between Home and Community-Based Services and Rates of Nursing Home Residency with Special Attention to Nutrition Programs

David R. Buys Center for Outcomes and Effectiveness Research and Education, University of Alabama at Birmingham, Birmingham, Alabama, USA; Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA; Center for Aging, University of Alabama at Birmingham, Birmingham, Alabama, USACorrespondence[email protected]

Casey Borch Department of Sociology, University of Alabama at Birmingham, Birmingham, Alabama, USA

Meredith Kilgore Center for Aging, University of Alabama at Birmingham, Birmingham, Alabama, USA; Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, Alabama, USA; Lister Hill Center for Health Policy, University of Alabama at Birmingham, Birmingham, Alabama, USA

Claire A. Zizza Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, Alabama, USA

Julie L. Locher Center for Outcomes and Effectiveness Research and Education, University of Alabama at Birmingham, Birmingham, Alabama, USA; Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA; Center for Aging, University of Alabama at Birmingham, Birmingham, Alabama, USA; Department of Sociology, University of Alabama at Birmingham, Birmingham, Alabama, USA; Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, Alabama, USA; Lister Hill Center for Health Policy, University of Alabama at Birmingham, Birmingham, Alabama, USA

Abstract

Federal food and nutrition programs implemented by the Administration on Aging and funded by the Older Americans Act (OAA) seek to enable older adults to remain in their homes and communities through a comprehensive, coordinated, and cost-effective array of services. We hypothesized that expenditures devoted to nutrition programs for home and community-based nutrition services were inversely related to changes in state-level rates of institutionalization for older adults from one year to the next, such that states that spend more money per capita on community-based nutrition programs would have smaller increases or greater decreases in rates of institutionalization, controlling for expenditures on other home and community-based services. We found, however, that there was not an effect of OAA Nutrition Services on the change in rates of nursing home residency. We noted, though, that states that direct a greater proportion of their long-term care expenditures to home and community-based services appear to have more reduction in their rates of nursing home residency. Further longitudinal work at the state and individual levels is warranted.

KEYWORDS:

Notes

Note. Instit., institutionalization.

^aRates are per 1000 individuals.

*Change in Rate of Inst. = Rate of institutionalized persons 65 (2008) – Rate of institutionalized persons 65 (2007).

**Rate of Change in Inst. = Change in Rate of Inst./Rate of institutionalized persons 65 (2007).

Note. CM, congregate meals; HCBS, home and community-based services; HDM, home-delivered meals; LTC, long-term care.

^aGross state product is in millions of dollars.

^bPer capita expenditures are in dollars per non-institutionalized older adult.

Note. LTC, long-term care; HCBS, home and community-based services; NIOA, noninstitutionalized older adults. Standard error is reported in parenthesis under the slope coefficient.

*P < .05; **P < .01; ***P < .0 01 (two-tailed tests).

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Order Reprints Request Corporate Permissions

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

Request Academic Permissions

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.

A State-Level Examination of the Association Between Home and Community-Based Services and Rates of Nursing Home Residency with Special Attention to Nutrition Programs

Information for

Open access

Opportunities

Help and information

A State-Level Examination of the Association Between Home and Community-Based Services and Rates of Nursing Home Residency with Special Attention to Nutrition Programs

Abstract

Notes

Reprints and Corporate Permissions

Academic Permissions

Related research

To cite this article:

Download citation

Information for

Open access

Opportunities

Help and information

Keep up to date

Your download is now in progress and you may close this window

Login or register to access this feature