Health Care Use Before and After Entering Long-Term Services and Supports.
OBJECTIVE
We examined the health care utilization patterns of Medicare and Medicaid enrollees (MMEs) before and after initiating long-term care in the community or after admission to a nursing facility (NF).


METHODS
We used administrative data to compare hospitalizations, emergency department (ED) visits, and post-acute care use of MMEs receiving long-term care in California in 2006-2007.


RESULTS
MMEs admitted to a NF for long-term care had much greater use of hospitalizations, ED visits, and post-acute care before initiating long-term care than those entering long-term care in the community. Post-entry, community service users had less than half the average monthly hospital and ED use compared with the NF cohort.


CONCLUSIONS
Hospital and ED use prior to and following NF and personal care program entry suggest a need for reassessing the monitoring of these high-risk populations and the communication between health and community care providers.
1 University of California, San Francisco, CA, USA.
Robert
R
Newcomer
1 University of California, San Francisco, CA, USA.
Charlene
C
Harrington
1 University of California, San Francisco, CA, USA.
Denis
D
Hulett
1 University of California, San Francisco, CA, USA.
Taewoon
T
Kang
1 University of California, San Francisco, CA, USA.
Michelle
M
Ko
1 University of California, San Francisco, CA, USA.
Andrew
A
Bindman
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008134:Long-Term Care; D008137:Longitudinal Studies; D008297:Male; D008484:Medicaid; D006278:Medicare; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult
emergency department use; home and community-based services; hospital use; nursing facilities; personal care