Abstract:

The purpose of this study is to report information about the distribution between community and long-term institutional care of urban elderly over a nine-year period. In 1975, a random sample of 1,598 noninstitutionalized persons aged 65 and over living in Cleveland, Ohio, were interviewed using the Duke OARS (Older Americans Resources and Services) instrument. Follow-up interviews were conducted in 1984 with 80 percent of the survivors and with proxies for 81 percent of the deceased. Results showed that 11.8 percent of the survivors were living in an institution at the time of the follow-up interview, and 10.7 percent of all survivors (institutionalized and noninstitutionalized) had been admitted to a long term care institution for 30 days or more. Mental health impairment and functional disability were associated with institutionalization, but the chances of remaining in the community were not affected by the presence of multiple chronic conditions. Multivariate logistic regression was performed to analyze whether it would have been possible at the beginning of the study to predict who would experience long-term institutionalization and who would remain in the community. Factors significantly favoring continued care in the community included younger age, male gender, income greater than $5,000 in 1975, and living with children only. Results indicate that socioeconomic factors predominate as predictors of long term care in the community.