title: Predicting long-term nursing home transfer from MI choice waiver program.
abstract: This study aimed to identify characteristics of elderly participants in the Michigan Home and Community-Based Waiver Program that are associated with high risk of long-term nursing home (LT-NH) placement. We identified 8172 waiver clients aged 65 and older during 10/1/2010-9/30/2014. A proportional cause-specific hazards regression model was used to analyze risk factors of waiver elderly for LT-NH placement. Waiver elderly participants who were white (HR (white vs. black): 2.76, with 95% CI (1.91, 4.00); HR (white vs. other races): 1.77, with 95% CI (1.05, 2.97)), had a history of long-term care use (HR: 1.42, 95% CI (1.14, 1.76)), mental disorders (HR: 1.51, 95% CI (1.23, 1.86)), bathing dependency (HR: 1.43, 95% CI (1.07, 1.89)), and finance management dependency (HR: 1.73, 95% CI (1.15, 2.60)) had greater hazards of LT-NH placement. Our study can be useful for policy makers to develop relevant support to reduce LT-NH placement.
authors.affiliation: Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, USA. Electronic address: wuxiaoti@msu.edu.
authors.forename: Xiaoting
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, USA.
authors.forename: Chenxi
authors.initials: C
authors.lastname: Li
authors.affiliation: Institute for Health Policy, College of Human Medicine, Michigan State University, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Oberst
authors.affiliation: Institute for Health Policy, College of Human Medicine, Michigan State University, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Given
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D002755:Choice Behavior; D006299:Health Services for the Aged / Q000191:economics / Q000458:organization & administration; D006699:Home Care Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D057187:Independent Living / Q000191:economics; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008484:Medicaid / Q000191:economics*; D008824:Michigan; D009735:Nursing Homes / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States
keywords: Cause-specific COX regression; Competing risk; Elderly; Long-term nursing home placement; MI choice waiver program; Nursing home; Risk factors