Forecasting the nursing home population.
OBJECTIVE
To forecast growth in the US nursing home population, as a function of trends in disability and marriage.


METHODS
Nursing home residence is modeled as a function of disability status, marital status, and other demographic covariates. Our predictions for nursing home residence are built upon joint forecasts of marriage and disability. We use data from the 1992 to 1996 Medicare Current Beneficiary Surveys, which are individual-level data sets designed to be representative of the US population older than the age of 65.


RESULTS
Today's young cohorts will have higher rates and levels of institutionalization than their older counterparts. This will reverse several decades of decline in rates of disability and institutionalization. The nursing home population is likely to be 10-25% higher than would be suggested by a simple extrapolation of past declines in disability.


CONCLUSIONS
In recent years, the rate of institutionalization among the elderly has been falling. It is predicted that this trend will reverse itself within the next decade, and that we will see substantial increases in the incidence of institutionalization among the elderly. This result is generated by our prediction of rising disability among the younger cohorts that are beginning to approach old age.
Lakdawalla
Darius
D
RAND Health, Santa Monica, California, USA. darius@rand.org
Goldman
Dana P
DP
Bhattacharya
Jay
J
Hurd
Michael D
MD
Joyce
Geoffrey F
GF
Panis
Constantijn W A
CW
D000203:Activities of Daily Living; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D006233:Persons with Disabilities; D004493:Education; D005260:Female; D005544:Forecasting; D006304:Health Status; D006630:Hispanic or Latino; D006707:Homes for the Aged / Q000639:trends*; D006801:Humans; D007182:Income; D007326:Institutionalization / Q000639:trends*; D008297:Male; D008393:Marriage / Q000639:trends; D006278:Medicare; D008962:Models, Theoretical; D009735:Nursing Homes / Q000639:trends*; D012737:Sex Factors; D014481:United States