South Carolina maintains a multidimensional gatekeeping assessment program to certify financially qualified individuals with disabilities as requiring some form of Medicaid long-term care [LTC]. An earlier study found race to be a strong predictor of entry into community vs. institutional programs. Our objective here is to explore differences in predictors of nursing home [NH] entry between Whites and African-American subgroups. A community cohort qualifying for LTC between 1994 and 1998 was identified. Data were derived from SC Medicaid records. The first admission to either the community-based waiver program or NHs with six months subsequent to baseline qualifying assessment was taken as placement outcome. Data were analyzed with nonparametric and logistic regression methods. Different predictors of NH placement were identified in Whites and African-Americans. Among predisposing variables, age and sex were significantly different between the two: advanced age was strongly associated with NH entry for Whites, but not for African-Americans, while sex was non-significant for Whites, but very important for NH entry among African-Americans. Enabling and need variables were also identified as variably significant in the two groups. Although the results showed the significant differences in predictors between the two ethnic groups, the causes of differential entry into community-based vs. institutional care are unclear. For example, they may reflect cultural preferences, access barriers, or other factors. Appropriate state policy decisions hinge upon disentangling these factors.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. Identify five most important predictors of nursing home entry for Whites and African-Americans. 2. Compare and contrast the different predictors of nursing home placement between Whites and African-Americans. 3. Discuss and develop possible long-term care management and policy implications for different ethnic groups.
Keywords: Nursing Homes, Community-Based Health Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.