Nursing Home Admissions Among Medicaid HCBS Enrollees Evidence of Racial/Ethnic Disparities or Differences?
Nursing Home Admissions Among Medicaid HCBS Enrollees Evidence of Racial/Ethnic Disparities or Differences?
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DOI：
10.1097/mlr.0000000000000379
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发表时间：
2015-07-01
期刊：
影响因子：
3
通讯作者：
Temkin-Greener, Helena
中科院分区：
文献类型：
--
作者：
Cai, Xueya;Temkin-Greener, Helena
目标：在机构护理和以家庭和社区为基础的服务（HCBS）之间重新平衡长期护理系统已成为大多数州医疗补助计划和《平价医疗法案》的几项规定的重要政策目标。本研究估计养老院入院模式的种族和民族在回顾性队列的医疗保险和医疗补助双重合格的个人谁参加了Medicaid HCBS programmes.Study Design：我们分析了2006年医疗补助分析eXtract个人摘要文件从19个州，并将这些数据与养老院最小数据集和其他文件。我们使用多变量竞争风险比例风险模型来估计黑人和西班牙裔HCBS登记者与白色登记者相比短期和长期入住疗养院的2年风险。结果：在93，508名老年人（65岁及以上）和新的HCBS使用者中，黑人2年长期入住疗养院的比率为10.16%[n= 18，000;风险比（HR）=0.80，P
Objectives:Rebalancing the long-term care system between institutional care and home-based and community-based services (HCBS) has become an important policy goal of most state Medicaid programs and several provisions of the Affordable Care Act. This study estimated nursing home admission patterns by race and ethnicity in a retrospective cohort of Medicare and Medicaid dually eligible individuals who enrolled in Medicaid HCBS programs.Study Design:We analyzed the 2006 Medicaid Analytic eXtract personal summary files from 19 states, and linked these data to nursing home Minimum Data Sets and other files. We used multivariable competing risk proportional hazard models to estimate 2-year risks of short-term and long-term nursing home admissions for black and Hispanic HCBS enrollees, compared with white enrollees. We also compared racial/ethnic differences in physical and cognitive impairments at the time of nursing home admissions.Results:Among 93,508 older (65 y and above) and new HCBS users, the 2-year long-term nursing home admission rates were 10.16% for blacks [n=18,000; hazard ratio (HR)=0.80, P