ArticleHealth services research2021
Nursing home admissions for persons with dementia: Role of home- and community-based services.
Article in Health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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
17 citing papers in PubMed.
- Medicaid Home and Community-Based Services Initiation and Acute Services Use.JAMA health forum · 2026Article
- Examining State Policies and Administrative Factors as Determinants of Consumer-Reported Unmet Service Needs in Publicly Funded Home- and Community-Based Services in the United States.Journal of market access & health policy · 2025Article
- Association of health-care and long-term care resources for patients with dementia with institutionalization and death: Evidence from South Korea.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Service Utilization and Consumer-Reported Unmet Needs in Medicaid Home- and Community-Based Services for Older Adults.Journal of aging & social policy · 2025Article
- Home health utilization in the Veterans Health Administration: Are there rural and urban differences?The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- The role of Medicaid home- and community-based services in use of Medicare post-acute care.Health services research · 2024Article
- Outcomes After Community Discharge From Skilled Nursing Facilities: The Role of Medicaid Home and Community-Based Services.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2024Article
- Changing places: Longitudinal trends in living arrangements of persons living with dementia.Journal of the American Geriatrics Society · 2024Article
- Barriers and Facilitators to Home- and Community-Based Services Access for Persons With Dementia and Their Caregivers.The journals of gerontology. Series B, Psychological sciences and social sciences · 2023Article
- Use of long-term services and supports among dual-eligible beneficiaries with Alzheimer's disease and related dementias.Journal of the American Geriatrics Society · 2023Article
- Trends In Medicaid Home And Community-Based Services Waivers For Older Adults.Health affairs (Project Hope) · 2022Article
- HCBS Service Spending and Nursing Home Placement for Patients With Alzheimer's Disease and Related Dementias: Does Race Matter?Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2022Article
- Applying Apriori algorithm to explore long-term care services usage status-Variables based on the combination of patients with dementia and their caregivers.Frontiers in psychology · 2022Article
- Nursing home admissions for persons with dementia: Role of home- and community-based services.Health services research · 2021Article
- Medicaid Home and Community Based Services Spending and Nursing Home Use by Individuals Under the Age of 44.Inquiry : a journal of medical care organization, provision and financingArticle
- "I'll fill in the gaps": perspectives of HHAs on promoting aging in place for older adults with low incomes.Home health care services quarterlyArticle
- The relationship between Medicaid policy and realized access to home- and community-based services.Home health care services quarterlyArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
objectiveTo examine the relationship between Medicaid home- and community-based services (HCBS) generosity and the likelihood of nursing home (NH) admission for dually enrolled older adults with Alzheimer's disease and related dementias (ADRD) and their level of physical and cognitive impairment at NH admission. DATA SOURCES: National Medicare data, Medicaid Analytic eXtract, and MDS 3.0 for CY2010-2013 were linked. STUDY
designEligible Medicare-Medicaid dual beneficiaries with ADRD were identified and followed for up to a year. We constructed two measures of HCBS generosity, breadth and intensity, at the county level for older duals with ADRD. Three binary outcomes were defined as follows: any NH placement during the follow-up year for all individuals in the sample, high (vs. not high) physical impairment, and high (vs. not high) cognitive impairment at the time of NH admission for those who were admitted to an NH. Logistic regressions with state-fixed effects and county random effects were estimated for these outcomes, respectively, accounting for individual- and county-level covariates. DATA EXTRACTION
methodsThe study sample included 365,310 community-dwelling older dual beneficiaries with ADRD who were enrolled in fee-for-service Medicare and Medicaid between October 1, 2010, and December 31, 2012. PRINCIPAL
findingsConsiderable variations of breadth and intensity in county-level HCBS were observed. We found that a 10-percentage-point increase in HCBS breadth was associated with a 1.4 (p < 0.01)-percentage-point reduction in the likelihood of NH admission. Among individuals with NH admission, greater HCBS breadth was associated with a higher level of physical impairment, and greater HCBS intensity was associated with a higher level of physical and cognitive impairment at NH admission.
conclusionsAmong community-dwelling duals with ADRD, Medicaid HCBS generosity was associated with a lower likelihood of NH admission and greater functional impairment at NH admission.
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Registered trials
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