title: Analysing access to nursing home care.
abstract: The aim of this study is to investigate access to nursing home care in selected regions of Australia, Canada and the United States, and to examine the common ways in which nursing homes are used. Firstly, a review of methodological considerations in measuring access to nursing home care is made. Secondly, patient turnover patterns are interpreted with a view to showing differences in nursing home use among the countries studied; aggregate turnover rates, length of stay and outcomes are compared. Thirdly, groups of patients who differ in demographic and morbidity characteristics and in their use of nursing homes are discussed. Finally a number of distributive implications of these results are raised and a framework is outlined for considering redistributive consequences of changes in the use of nursing homes. It is concluded that the rate of flow of patients through nursing homes is as important a determinant of access to nursing home care as the level of bed provision and that adoption of this dynamic view of access indicates considerable scope for redistributing use of resources within the nursing home systems of all three countries.
mesh_terms: D000368:Aged; D001315:Australia; D002170:Canada; D006297:Health Services Accessibility; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D009735:Nursing Homes / Q000706:statistics & numerical data*; D014481:United States