Abstract:

The aging of the population is and will be one of the most important social trends of the next century in the United States. One consequence of an aging population is the increased cost of long-term care. In order to correctly identify the potential users of different types of long-term care services, policy makers need to understand the determinants that affect the type and amount of care used by the elderly and the risk determinants of being institutionalized. To identify the factors influencing the utilization of nursing homes and community-based home care services by the elderly, Andersen's behavioral model was examined with three different methods of analysis--cross-sectional, time-lagged, and hazard models. The effect of the utilization of community-based home care services on nursing home entry are also examined. The analyses were based on responses from the 1986, 1988, and 1990 Longitudinal Study of Aging (LSOA). The results show that the characteristics of those who used nursing home care and paid home care services were different. Understanding the differences in characteristics which predict long-term care services is critical to the development and planning of services for the older population. This study, which also showed that the use of community-based home care may deter nursing home entry, gives the rationale for increasing public financing and for expansion of community-based long-term care. By making community-based home care more available and accessible to elderly people, it is expected that more elderly will be able to receive better quality care at a reasonable cost.