ArticleArchives of internal medicine2011
Geographic concentration and correlates of nursing home closures: 1999-2008.
Article in Archives of internal medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- Racial Segregation Across U.S. Nursing Homes: A Systematic Review of Measurement and Outcomes.The Gerontologist · 2020Pooled it
- Racial/Ethnic Disparities in Influenza and Pneumococcal Vaccinations Among Nursing Home Residents: A Systematic Review.The Gerontologist · 2018Pooled it
- A longitudinal machine-learning approach to predicting nursing home closures in the U.S.npj health systems · 2026Article
- Medicaid payment rates and nursing home staffing levels across ownership types.Innovation in aging · 2026Article
- Financial performance of rural and urban nursing homes: A comparative analysis.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- The frequency and types of resident relocations in Dutch nursing homes: a nationwide cohort study of electronic health record data.European geriatric medicine · 2024Article
- Does outsourcing enable the survival of good care homes? A longitudinal analysis of all care homes in England, 2011-2023.BMJ public health · 2024Article
- Access and care for people with opioid use disorder in U.S. skilled nursing facilities: A policy commentary.The International journal on drug policy · 2024Article
- Medicare skilled nursing facilities' occupancy and payer source: The moderating role of financial performance.SAGE open medicine · 2024Article
- Rates of nursing home closures were relatively stable over the past decade, but warrant continuous monitoring.Health affairs scholar · 2023Article
- The effect of nursing home closure on local employment in the United States.Health services research · 2023Article
- Animal welfare deserts: human and nonhuman animal inequities.Frontiers in veterinary science · 2023Article
- Socio-Spatial Disparities in County-Level Availability of Aging and Disability Services Organizations.Journal of rural social sciences · 2022Article
- Putting the Nursing and Home in Nursing Homes.Innovation in aging · 2022Article
- Adapting Andersen's expanded behavioral model of health services use to include older adults receiving long-term services and supports.BMC geriatrics · 2020Article
- Quality of Post-Acute Care in Skilled Nursing Facilities That Disproportionately Serve Black and Hispanic Patients.The journals of gerontology. Series A, Biological sciences and medical sciences · 2019Article
- Geographic Disparities in Access to Nursing Home Services: Assessing Fiscal Stress and Quality of Care.Health services research · 2018Article
- Rebalance Without the Balance: A Research Note on the Availability of Community-Based Services in Areas Where Nursing Homes Have Closed.Research on aging · 2017Article
- The determinants of care home closure.Health economics · 2015Article
- Higher Medicare SNF care utilization by dual-eligible beneficiaries: can Medicaid long-term care policies be the answer?Health services research · 2015Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundWhile demographic shifts project an increased need for long-term care for an aging population, hundreds of nursing homes close each year. We examine whether nursing home closures are geographically concentrated and related to local community characteristics such as the racial and ethnic population mix and poverty.
methodsNational Online Survey Certification and Reporting data were used to document cumulative nursing facility closures over a decade, 1999 through 2008. Census 2000 zip code level demographics and poverty rates were matched to study facilities. The weighted Gini coefficient was used to measure geographic concentration of closures, and geographic information system maps to illustrate spatial clustering patterns of closures. Changes in bed supply due to closures were examined at various geographic levels.
resultsBetween 1999 and 2008, a national total of 1776 freestanding nursing homes closed (11%), compared with 1126 closures of hospital-based facilities (nearly 50%). Combined, there was a net loss of over 5% of beds. The relative risk of closure was significantly higher in zip code areas with a higher proportion of blacks or Hispanics or a higher poverty rate. The weighted Gini coefficient for closures was 0.55 across all metropolitan statistical areas and 0.71 across zip codes. Closures tended to be spatially clustered in minority-concentrated zip codes around the urban core, often in pockets of concentrated poverty.
conclusionsNursing home closures are geographically concentrated in minority and poor communities. Since nursing home use among the minority elderly population is growing while it is declining among whites, these findings suggest that disparities in access will increase.
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