title: Long-term care: who gets it, who provides it, who pays, and how much?
abstract: Long-term care in the United States is needed by 10.9 million community residents, half of them nonelderly, and 1.8 million nursing home residents, predominantly elderly. Ninety-two percent of community residents receive unpaid help, while 13 percent receive paid help. Paid community-based long-term care services are primarily funded by Medicaid or Medicare, while nursing home stays are primarily paid for by Medicaid plus out-of-pocket copayments. Per person expenditures are five times as high, and national expenditures three times as high, for nursing home residents compared to community residents. This suggests that a redistribution of spending across care settings might produce substantial savings or permit service expansions.
authors.affiliation: Institute for Health and Aging at the University of, California, San Francisco, California, USA. steve.kaye@ucsf.edu
authors.forename: H Stephen
authors.initials: HS
authors.lastname: Kaye
authors.forename: Charlene
authors.initials: C
authors.lastname: Harrington
authors.forename: Mitchell P
authors.initials: MP
authors.lastname: LaPlante
mesh_terms: D000328:Adult; D000368:Aged; D003153:Community Health Services / Q000191:economics* / Q000379:methods / Q000600:supply & distribution; D017046:Cost Savings / Q000379:methods*; D003669:Deductibles and Coinsurance; D005382:Financing, Personal / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics; D006302:Health Services Research; D006699:Home Care Services / Q000191:economics; D006801:Humans; D007902:Length of Stay / Q000191:economics; D016015:Logistic Models; D008134:Long-Term Care / Q000191:economics* / Q000379:methods; D008484:Medicaid / Q000191:economics; D006278:Medicare / Q000191:economics; D009735:Nursing Homes / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States