MINORITY ELDERLY ACCESS TO LONG-TERM CARE

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Access to long-term care (LTC) is a critical issue of racial and ethnic minority elderly because of their comparatively high levels of chronic disability. African-American and Hispanic elderly have levels of disability as high or higher than non-Hispanic white elderly, but African-American and Hispanic elderly are less likely to use nursing homes and more likely to receive informal support than non-Hispanic whites. Data on the use of formal community services is mixed. Access barriers to acute care for racial and ethnic minorities is well documented, but research is limited on the degree to which access barriers limit the use of long-term care by minority elderly. The proposed research will use the 1987 National Medical Expenditure Survey (NMES) to begin to investigate access barriers to the use of long-term care by 1. Comparing the use of nursing home, formal in-home, and informal long-term care by elderly African-Americans, Hispanics, and non-Hispanic whites; controlling for selected demographic, need, and resource/barrier differences in the populations. 2. Comparing the amount and sources of spending for nursing home and formal in-home care by elderly African-Americans, Hispanics, and non-Hispanic whites; controlling for demographic, need, and resource/barrier differences in the populations. Data are from a nationally representative sample of 710 African-American, 190 Hispanic, and 4786 non-Hispanic white elders living in the community and 456 African-American, 137 Hispanic, and almost 4400 non-Hispanic white elderly in nursing homes. As preliminary research, most analysis will be descriptive. Point estimates, rates, and confidence intervals will be created for receipt and expenditures by source on all long-term care, nursing home care, formal in-home services, and informal long-term care by race and ethnicity. The relative effects of differences between populations will be explored by standardizing them on key variables. The hypothesis is that, given similar levels of disability and other characteristics, minority elderly will be using lower levels of both institutional and noninstitutional long-term care.