This study was designed to examine the relationship between attitudes toward nursing homes and subsequent nursing home utilization, and assess the impact of prior nursing home utilization on subsequent attitudes among a national sample of older Americans. Multivariate estimation procedures for complex survey designs were performed on the National Long-Term Care Survey data set. Although prior nursing home use did not directly affect subsequent attitudes toward nursing homes, having favorable attitudes about nursing homes increased the odds of using subsequent nursing home services by 1.5 and increased the total nursing home length of stay by 17%. Implications of this research for public policy and long-term care treatment planning are discussed.
Get full access to this article
View all access options for this article.
References
1.
Andersen, R. M. , McCutcheon, A., Aday, L. A., Chiu, G. Y., & Bell, R. (1983). Exploring dimensions of access to medical care. Health Services Research, 18(1): 49-74.
2.
Andersen, R. , & Newman, J. (1973). Societal and individual determinants of medical care utilization in the United States. The Milbank Quarterly, 51, 95-124.
3.
Benjamin, A. E. (1992). An overview of in-home health and supportive services for older persons. In M. G. Ory & A. P. Duncker (Eds), In-home care for older people (pp. 9-52). Newbury Park, CA: Sage.
4.
Berry, D. E. , & Beaulieu, J. E. (1994). Supply of hospital and long-term care services in rural areas. In J. E. Beaulieu and D. E. Berry (Eds.), Rural health services: A management perspective (pp. 111-142). Ann Arbor, MI: AUPHA Press/Health Administration Press.
5.
Branch, L. G. , & Jette, A. M. (1982). A prospective study of long-term care institutionalization among the aged. American Journal of Public Health, 72, 1373-1379.
6.
Center for Demographic Studies . (1994). Personal correspondence with staff. Durham, NC: Duke University.
7.
Cohen, M. , Tell, E. J., & Wallack, S. S. (1986). Client-related risk factors of nursing home entry among elderly adults. Journal of Gerontology, 41, 785-792.
8.
Davidson, H. A. , & O'Connor, B. P.. (1990). Perceived control and acceptance of the decision to enter a nursing home as predictors of adjustment. International Journal of Aging and Human Development, 31, 307-318.
9.
Dowd, B. E. , Johnson, A. N., & Madson, R. A. (1986). Inpatient length of stay in twin cities health plans. Medical Care, 24, 694-710.
10.
Evashwick, C. , Rowe, G., Diehr, P., & Branch, L. (1984). Factors explaining the use of health care services by the elderly. Health Services Research, 19, 357-382.
11.
Gass, K. A. , Gaustad, G., Oberest, M. T., & Hughes, (1992). Relocation, appraisal, functional independence, morale, and health of nursing home residents. Issues in Mental Health Nursing, 13, 239-253.
12.
Greene, V. L. (1984). Premature institutionalization among the rural elderly in Arizona. Public Health Reports, 99, 58-63.
13.
Groger, L. (1994). Decision as process: A conceptual model of Black elder's nursing home placement. Journal of Aging Studies, 8(1), 77-94.
14.
Gujarati, D. N. (1988). Basic econometrics (2nd ed.). New York: McGraw-Hill.
15.
Guterman, S. , Eggers, P. W., Riley, G., Greene, T. F., & Terrell, S. A. (1988). The first three years of Medicare prospective payment: An overview. Health Care Financing Review, 9, 67-77.
16.
Halvorsen, R. , & Palmquist, R. (1980). The interpretation of dummy variables in semilogarithmic equations. American Economic Review, 70(3), 474-475.
17.
Inter-university Consortium for Political and Social Research (1994). ICPSR Bulletin, 14, 2-6.
18.
Johnson, R. A. , Schwiebert, V. B., & Rosenmann, P. A. (1994). Factors influencing nursing home placement decisions: The older adult's perspective. Clinical Nursing Research, 3, 269-281.
19.
Kane, R. L. , & Kane, R. (Eds.). (1982). Values and long-term care. Lexington, MA: Lexington Books.
20.
Keeler, E. , & Kane, R. L. (1982). What is special about long-term care? In R. L. Kane & R. Kane (Eds.), Values and long-term care (pp. 85-100). Lexington, MA: Lexington Books.
21.
Kennedy, P. (1989). A guide to econometrics (4th ed.). Cambridge, MA: MIT Press.
22.
Lessler, J. T. , & Kalsbeek, W. D. (1992). Nonsampling error in surveys. New York: John Wiley.
23.
McAuley, W. J. , & Blieszner, R. (1985). Selection of long-term care arrangements by older community residents. The Gerontologist, 25, 188-193.
24.
Meiners, M. R. , & Coffey, R. M. (1985). Hospital DRGs and the need for long-termcare services: An empirical analysis. Health Services Research, 20, 359-384.
25.
Morns, J. N. , Sherwood, S., & Gutkin, C. E. (1988). Inst-risk II: An approach to forecasting relative risk of future institutional placement. Health Services Research, 23, 511-536.
26.
Noelker, L. S. , & Bass, D. M. (1989). Home care for elderly persons: Linkages between formal and informal caregivers. Journal of Gerontology, 44, S63-S70.
27.
Norbum, J. E. , Bernard, S. L., Konrad, T. R., Woomert, A., DeFriese, G. H., Kalsbeek, W. D., & Koch, G. G. (1995). Self-care and assistance from others in coping with functional status limitations among a national sample of older adults. Journal of Gerontology, 50, S101-S109.
28.
Parris-Stephens, M. A. (1993). Understanding barriers to caregivers' use of formal services: The caregiver's perspective. In S. H. Zarit, L. I. Pearlin, & K. W. Schaie (Eds.), Caregiving systems: Informal and formal helpers (pp. 261-271). Hillsdale, NJ: Lawrence Erlbaum.
29.
Rabiner, D. (1995). Patterns and predictors of non-institutional health care utilization by older adults in rural and urban America. Journal of Rural Health, 11, 259-273.
30.
Rabiner, D. J. , Steams, S. C., & Mutran, E. (1994). The effect of channeling on in-home utilization and subsequent nursing home care: A simultaneous equation perspective. Health Services Research, 29, 605-621.
31.
Reinardy, J. R. (1992). Decisional control in moving to a nursing home: Post admission adjustment and well-being. The Gerontologist, 32, 96-103.
32.
Shah, B. V. , Barnwell, B. G., Hunt, P. N., & LaVange, L. M. (1991). SUDAAN user s manual. Research Triangle Park, NC: Research Triangle Institute.
33.
Shapiro, E. , & Tate, R. B. (1988). Who is really at risk for institutionalization?The Gerontologist, 28(2), 237-245.
34.
Shaughnessy, P. W. (1994). Changing institutional long-term care to improve rural health care. In R. T. Coward, C. N. Bull, G. Kukulka, & J. M. Galliher (Eds), Health services for rural elders (pp. 144-181). New York: Springer.
35.
Stoller, E. (1982). Patterns of physician utilization by the elderly: A multivariate analysis. Medical Care, 20, 1080-1089.
36.
Tickle, E. H. (1993). T-he relationship of health care experience to satisfactory relocation in long-term care. Nursing Connections, 6, 13-24.
37.
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation , & the Health Care Financing Administration. (1989). National Long-Term Care Survey 1982-84 (computer file). Washington, DC: U.S. Department of Commerce. Bureau of the Census, and National Opinion Research Center, 1984 (producers). Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], Vols. I and II.
38.
Weissert, W. G. (1985). Estimating the long-term care population: Prevalence rates and selected characteristics. Health Care Financing Review, 6, 83-91.
39.
Weissert, W. G. , & Cready, C. M. (1989). Toward a model for improved targeting of aged at risk of institutionalization. Health Services Research, 24, 485-510.
40.
Weissert, W. G. , Cready, C. M., & Pawelak, J. E. (1988). The past and future of home and community-based long-term care. The Milbank Quarterly, 66, 1-79.
41.
Wolinsky, F. D. , & Arnold, C. L. (1988). A different perspective on health and health services utilization. Annual Review of Gerontology and Geriatrics, 8, 71-101.
42.
Wolinsky, F. D. , & Coe, R. M. (1984). Physician and hospital utilization among noninstitutionalized elderly adults: An analysis of the Health Interview Survey. Journal of Gerontology, 39, 334-341.
43.
Wolinsky, F. D. , Culler, S. D., Callahan, C. M., & Johnson, R. J. (1994). Hospital resource consumption among older adults: A prospective analysis of episodes, length of stay, and charges over a seven-year period. Journal of Gerontology, 49, S240-S252.
