title: Assisted living expansion and the market for nursing home care.
abstract: OBJECTIVE
  To analyze the effect of market-level changes in assisted living supply on nursing home utilization and resident acuity.
  
  
  METHODS
  Primary data on the supply of assisted living over time were collected from 13 states from 1993 through 2007 and merged with nursing home-level data from the Online Survey Certification and Reporting System and market-level information from the Area Resource File.
  
  
  METHODS
  Least squares regression specification incorporating market and time-fixed effects.
  
  
  RESULTS
  A 10 percent increase in assisted living capacity led to a 1.4 percent decline in private-pay nursing home occupancy and a 0.2-0.6 percent increase in patient acuity.
  
  
  CONCLUSIONS
  Assisted living serves as a potential substitute for nursing home care for some healthier individuals with greater financial resources, suggesting implications for policy makers, providers, and consumers.
authors.affiliation: Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115-5899, USA. grabowski@med.harvard.edu
authors.forename: David C
authors.initials: DC
authors.lastname: Grabowski
authors.forename: David G
authors.initials: DG
authors.lastname: Stevenson
authors.forename: Portia Y
authors.initials: PY
authors.lastname: Cornell
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D040561:Assisted Living Facilities / Q000191:economics / Q000706:statistics & numerical data*; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D006707:Homes for the Aged / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008483:Medical Assistance / Q000191:economics / Q000706:statistics & numerical data; D009735:Nursing Homes / Q000191:economics / Q000706:statistics & numerical data*; D010067:Ownership / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data