Friday, April 28, 2006

HHS Report: The Size and Characteristics of the Residential Care Population: Evidence from Three National Surveys

Here's the Executive summary: 

National data collections have only recently begun to respond to the need for data on growth in residential care alternatives to both traditional nursing homes and care at home for older persons with disability. This information is critical to understanding the evolving long-term care delivery system and to the ability to monitor care arrangements and quality for public policy and for consumer information.

This report is the second of two prepared as part of a project to better understand the size and characteristics of the long-term care population in all settings. The first report reviewed existing estimates of the older population in residential care, generally divided into nursing homes and alternative residential care settings. Substantial variation was found across different types of data and even across studies using the same data, and differences in estimates generally were larger for residential alternatives than for nursing homes (Spillman and Black 2005). As part of that report, we identified a set of key methodological issues contributing to observed differences in existing estimates that could be investigated using available national surveys.

They are:

  • age of the population examined,
  • sample representation and weighting,
  • methods for assigning individuals to the “facility” or   “institutional” population (and conversely, the “community”   or “noninstitutional” population),
  • methods of identifying nursing homes,
  • methods of identifying alternative residential care settings.

We also identified three recent federally supported surveys--the 2002 Health and Retirement Survey (HRS), the 2002 Medicare Current Beneficiary Survey (MCBS) Cost and Use file, and the National Long Term Care Survey (NLTCS)--as being best suited for the purpose because of their focus on the older population and data elements that allow identification of residential care alternatives by name, services, or both. In this study, we report on our analysis of these surveys and discuss the implications of our findings for improving collection of data on residential settings.

The report is available here.

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