title: Racial segregation and quality of care disparity in US nursing homes.
abstract: In this paper, we examine the contributions of travel distance and preferences for racial homogeneity as sources of nursing home segregation and racial disparities in nursing home quality. We first theoretically characterize the distinctive implications of these mechanisms for nursing home racial segregation. We then use this model to structure an empirical analysis of nursing home sorting. We find little evidence of differential willingness to pay for quality by race among first-time nursing home entrants, but do find significant distance and race-based preference effects. Simulation exercises suggest that both effects contribute importantly to racial disparities in nursing home quality.
authors.affiliation: Department of Health Services Policy and Practice, Brown University, Box G-S121(6), Providence, RI 02912, United States. Electronic address: Momotazur_Rahman@brown.edu.
authors.forename: Momotazur
authors.initials: M
authors.lastname: Rahman
authors.affiliation: Department of Economics and Health Services Policy and Practice, Brown University, 64 Waterman street, Providence, RI 02912, United States. Electronic address: afoster@brown.edu.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Foster
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000592:standards / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000706:statistics & numerical data; D063505:Racism / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data; D014481:United States; D044465:White People / Q000706:statistics & numerical data
keywords: Distance; Instrumental variable; Nursing home sorting; Quality of care; Race; Segregation