title: Is Aging in Place Delaying Nursing Home Admission?
abstract: OBJECTIVE
  This study examines whether aging in place (community-based living before admission to a nursing home) delays nursing home admission among New York State home health care recipients.
  
  
  METHODS
  Retrospective cohort study (January 2007-December 2012).
  
  
  METHODS
  New York State.
  
  
  METHODS
  Adults age 65+ who received home health services for at least 2 months before permanent nursing home admission.
  
  
  METHODS
  Permanent transition is defined as home care patients who are discharged to and stay at a nursing home for more than 3 months. Data were abstracted from the Minimum Data Set (MDS) and Outcome and Assessment Information Set (OASIS). Descriptive and bivariate Kruskal-Wallis and χ(2) tests were performed.
  
  
  RESULTS
  The average age of nursing home residents at admission remained steady at 83 years between 2007 and 2012. The proportion of minority populations (Asian, black, Hispanic/Latino) increased, whereas the white population declined (P < .0001). The average length of stay at home increased 8 months, from 17 months in 2007 to 25 months in 2012 (P < .0001). Chronic conditions with significant increases in prevalence during the study period were hypertension (P < .0009), dementia (P < .0001), heart failure (P = .05), urinary incontinence (P < .0001), and bowel incontinence (P < .0001). Increases in functional disabilities requiring extensive human assistance included toileting, dressing, personal hygiene, and transferring (all P < .001).
  
  
  CONCLUSIONS
  Home health services enabled recipients to remain at home 8 months longer, thus delaying nursing home entry. Given the increase in prevalence of comorbidities and disability, we anticipate a concomitant increase in support services at the nursing home. These results may inform policy and staffing decisions regarding adjustments in required caregivers' credentials and nurse-patient ratios.
authors.affiliation: Department of Health Policy, Management, and Behavior, School of Public Health, State University of New York at Albany, Albany, NY. Electronic address: yyoung@albany.edu.
authors.forename: Yuchi
authors.initials: Y
authors.lastname: Young
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Albany, NY.
authors.forename: John
authors.initials: J
authors.lastname: Kalamaras
authors.affiliation: Department of Health Policy, Management, and Behavior, School of Public Health, State University of New York at Albany, Albany, NY.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Kelly
authors.affiliation: Homedical Associates, Albany, NY.
authors.forename: David
authors.initials: D
authors.lastname: Hornick
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Albany, NY.
authors.forename: Recai
authors.initials: R
authors.lastname: Yucel
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D057187:Independent Living; D008297:Male; D009518:New York / Q000453:epidemiology; D009735:Nursing Homes; D010343:Patient Admission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors
keywords: ADLs; Aging in place; home and community-based services; nursing home