America faces a crisis with the impending demand for long term care services by the """"""""Baby Boom"""""""" generation that will overwhelm current financing and delivery mechanisms. Although largely governmentally funded via Medicaid/Medicare, the privately operated component of the long term care industry is responsive to competitive market forces. The long term care industry -- nursing homes, home health agencies, assisted living and various forms of day care programming - has evolved in response to rising consumer demand, financing and regulatory policy changes. The proposed Program Project will examine the policies and market forces that influence the strategic choices of long term care providers as well as the outcomes the target population experiences. Building on two decades of research examining outcomes experienced by nursing home residents, faculty from the Brown University Center for Gerontology and Health Care Research in conjunction with colleagues at Dartmouth College and the University of Rochester propose to study the effects state and federal policies, as well as local market forces, have on the long term care industry. The proposed LTC P01 represents the """"""""culmination"""""""" of years of research establishing the viability of working with secondary data, merged with various sources of primary data, to test the impact of changing state policies and market forces. We will build a data infrastructure to serve the four (4) projects proposed that characterizes the structure, functioning and quality of care of nursing homes and will make the resulting data available to the research community. The overall objectives of the program project are to: 1. Build a long term care data and policy repository and analysis infrastructure as the basis for currently proposed and future projects examining the nation's long term care """"""""system"""""""";2. Implement a survey of states'policies and a national sample of nursing homes, integrating them with secondary data to serve the proposed research projects;3. Integrate economic and organizational theory to develop measures and to propose testable hypotheses in the proposed projects focusing on providers'responses to market and policy changes;4. Systematically catalogue and broadly disseminate to numerous audiences project findings by academic publications, promoting (via KFF.org) a web-site providing access to state policy, market and """"""""de-identified"""""""" provider data for use by researchers and policy analysts. Lay Summary: This program project will examine the influence state policies have on the behavior and functioning of US nursing homes and the outcomes their patients experience.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Program Projects (P01)
Project #
3P01AG027296-05S1
Application #
8542405
Study Section
Special Emphasis Panel (ZAG1-ZIJ-9 (O2))
Program Officer
Baker, Colin S
Project Start
2007-09-15
Project End
2013-06-30
Budget Start
2012-09-15
Budget End
2013-06-30
Support Year
5
Fiscal Year
2012
Total Cost
$81,000
Indirect Cost
$31,000
Name
Brown University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
001785542
City
Providence
State
RI
Country
United States
Zip Code
02912
Rivera-Hernandez, Maricruz; Rahman, Momotazur; Mukamel, Dana B et al. (2018) Quality of Post-Acute Care in Skilled Nursing Facilities That Disproportionately Serve Black and Hispanic Patients. J Gerontol A Biol Sci Med Sci :
Ogarek, Jessica A; McCreedy, Ellen M; Thomas, Kali S et al. (2018) Minimum Data Set Changes in Health, End-Stage Disease and Symptoms and Signs Scale: A Revised Measure to Predict Mortality in Nursing Home Residents. J Am Geriatr Soc 66:976-981
Keohane, Laura M; Trivedi, Amal N; Mor, Vincent (2018) The Role of Medicare's Inpatient Cost-Sharing in Medicaid Entry. Health Serv Res 53:711-729
Kosar, Cyrus M; Thomas, Kali S; Gozalo, Pedro L et al. (2018) Higher Level of Obesity Is Associated with Intensive Personal Care Assistance in the Nursing Home. J Am Med Dir Assoc 19:1015-1019
Kumar, Amit; Rahman, Momotazur; Trivedi, Amal N et al. (2018) Comparing post-acute rehabilitation use, length of stay, and outcomes experienced by Medicare fee-for-service and Medicare Advantage beneficiaries with hip fracture in the United States: A secondary analysis of administrative data. PLoS Med 15:e1002592
Berry, Sarah D; Zullo, Andrew R; Lee, Yoojin et al. (2018) Fracture Risk Assessment in Long-term Care (FRAiL): Development and Validation of a Prediction Model. J Gerontol A Biol Sci Med Sci 73:763-769
Thomas, Kali S; Silver, Benjamin; Gozalo, Pedro L et al. (2018) Constructing a Measure of Private-pay Nursing Home Days. Med Care 56:e26-e31
Rivera-Hernandez, Maricruz; Kumar, Amit; Epstein-Lubow, Gary et al. (2018) Disparities in Nursing Home Use and Quality Among African American, Hispanic, and White Medicare Residents With Alzheimer's Disease and Related Dementias. J Aging Health :898264318767778
Kosar, Cyrus M; Thomas, Kali S; Gozalo, Pedro L et al. (2018) Effect of Obesity on Postacute Outcomes of Skilled Nursing Facility Residents with Hip Fracture. J Am Geriatr Soc 66:1108-1114
McCreedy, Ellen M; Weinstein, Barbara E; Chodosh, Joshua et al. (2018) Hearing Loss: Why Does It Matter for Nursing Homes? J Am Med Dir Assoc 19:323-327

Showing the most recent 10 out of 160 publications