title: A review of factors influencing utilization of home and community-based long-term care: trends and implications to the nursing workforce.
abstract: Over the past several decades, home- and community-based services (HCBS) have played an increasingly important role in providing care to patients with complex health problems and functional impairments, and in enabling patients to remain independent in their own homes. This article identifies developments in U.S. health care policy during the past three decades that have led to increases in demand for and utilization of home- and community-based health care. We discuss the implications of these policy developments, societal trends, and the unique opportunities they present for the nursing workforce. Descriptive analyses of data from the 2008 National Sample Survey of Registered Nurses (N = 28,402) reveal significant differences between nurses employed in HCBS and hospital settings, and provide little evidence that the nursing workforce has responded to the shifting needs for nursing resources in HCBS.
authors: Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY 10001, USA. peri.rosenfeld@vnsny.org
authors: Peri
authors: P
authors: Rosenfeld
authors: David
authors: D
authors: Russell
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D003152:Community Health Nursing / Q000458:organization & administration* / Q000706:statistics & numerical data* / Q000639:trends; D003153:Community Health Services / Q000191:economics / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D005260:Female; D005544:Forecasting; D015577:Geriatric Assessment; D018166:Health Care Reform; D005102:Health Expenditures / Q000639:trends; D006291:Health Policy / Q000191:economics / Q000639:trends; D006280:Health Workforce / Q000191:economics / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009726:Nurses / Q000191:economics / Q000600:supply & distribution*; D014481:United States