Bruce Kinosian1, Eric Stallard, Darryl Wieland. 1. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA 19104, USA. brucek@mail.med.upenn.edu
Abstract
PURPOSE: The purpose of this article is to describe the projected use for long-term-care services through 2012. DESIGN AND METHODS: We constructed a static-component projection model using age, function, and other covariates. We obtained enrollee projections from the Veterans Health Administration (VHA) and combined these with nursing home and community long-term-care service use rates from the 1999 National Long-Term Care Survey and the 2000 National Health Interview Survey. RESULTS: Over the next decade, the number of oldest veterans (aged 85+) will double, and VHA-enrolled veterans aged 85 and older will increase sevenfold. This will result in a 20-25% increase in use for both nursing home and home- and community-based services. VHA currently concentrates 90% of its long-term-care resources on nursing home care. However, among those who receive long-term care from all formal sources, 56% receive care in the community. Age and marital status are significant predictors of use of either type of formal long-term-care service for any given level of disability. VHA's experience with the mandatory nursing home benefit suggests that even when the cost to the veteran is near zero, only 60-65% of eligibles will choose VHA-provided care. Assisted living represents nearly 15% of care provided during the past decade to individuals in nursing homes, and approximately 19% of veterans using nursing homes have disability levels comparable to those of men supported in assisted living. IMPLICATIONS: As most of the increased projected use for long-term care will be for home- and community-based services, VHA will need to expand those resources. Use of VHA resources to leverage community services may offer new opportunities to enhance community-based long-term care.
PURPOSE: The purpose of this article is to describe the projected use for long-term-care services through 2012. DESIGN AND METHODS: We constructed a static-component projection model using age, function, and other covariates. We obtained enrollee projections from the Veterans Health Administration (VHA) and combined these with nursing home and community long-term-care service use rates from the 1999 National Long-Term Care Survey and the 2000 National Health Interview Survey. RESULTS: Over the next decade, the number of oldest veterans (aged 85+) will double, and VHA-enrolled veterans aged 85 and older will increase sevenfold. This will result in a 20-25% increase in use for both nursing home and home- and community-based services. VHA currently concentrates 90% of its long-term-care resources on nursing home care. However, among those who receive long-term care from all formal sources, 56% receive care in the community. Age and marital status are significant predictors of use of either type of formal long-term-care service for any given level of disability. VHA's experience with the mandatory nursing home benefit suggests that even when the cost to the veteran is near zero, only 60-65% of eligibles will choose VHA-provided care. Assisted living represents nearly 15% of care provided during the past decade to individuals in nursing homes, and approximately 19% of veterans using nursing homes have disability levels comparable to those of men supported in assisted living. IMPLICATIONS: As most of the increased projected use for long-term care will be for home- and community-based services, VHA will need to expand those resources. Use of VHA resources to leverage community services may offer new opportunities to enhance community-based long-term care.
Authors: Kali S Thomas; Danielle Cote; Rajesh Makineni; Orna Intrator; Bruce Kinosian; Ciaran S Phibbs; Susan M Allen Journal: J Aging Soc Policy Date: 2018-01-08
Authors: Eric Jutkowitz; Christopher Halladay; John McGeary; Thomas O'Toole; James L Rudolph Journal: J Am Geriatr Soc Date: 2019-06-17 Impact factor: 5.562
Authors: Josephine C Jacobs; Todd H Wagner; Ranak Trivedi; Karl Lorenz; Courtney H Van Houtven Journal: Health Serv Res Date: 2021-06-03 Impact factor: 3.402