Journals of Gerontology Series B: Psychological Sciences and Social Sciences
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Journals of Gerontology Series B: Psychological Sciences and Social Sciences, Vol 53, Issue 4 S177-S187, Copyright © 1998 by The Gerontological Society of America

ARTICLES

Modeling lifetime nursing home use under assumptions of better health

SB Laditka
School of Business and Public Management, State University of New York Institute of Technology at Utica/Rome, USA. [email protected]

OBJECTIVES: There is evidence of notable improvement in active life expectancy among older Americans. Little is known, however, about the effect of better health on lifetime nursing home use. The purpose of this study was to address this gap in our knowledge. METHODS: Discrete- time hazard models of nursing home admission and discharge were developed using data from the 1982, 1984, and 1989 National Long Term Care Surveys and the 1984-1990 Longitudinal Study of Aging. Microsimulation techniques were used to incorporate monthly functional status information into the models that predict nursing home use and to generate lifetime nursing home histories for a cohort of older men and women under various assumptions of improved morbidity. RESULTS: Improved health increased total life expectancy and the absolute amount of time spent in both the community and in nursing homes. Better health did not change the proportion of life older persons spent in nursing homes or the percentage of the cohort who entered nursing homes. DISCUSSION: If morbidity improves there will be an increase in the use of nursing homes. However, for the majority of older persons, better health will be associated with more independent living throughout the life span.


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