Documenting Increased Nursing Home Use Among Hispanics
In the past twenty years, nursing homes have become more central in providing a broad range of both acute care and rehabilitation care functions, as elderly patients are discharged more quickly from hospitals and nursing home acuity levels have increased. However, both access to nursing homes and the quality of care received by elderly patients in nursing homes can be described as “separate” (nursing homes tend to be either well financed and located in resource-rich areas, or poorly equipped and located in poor communities) and “unequal” (poorer homes tend to have lower quality care processes and outcomes). Many factors are thought to contribute to this sorry picture, including patterns of residential segregation, local long term care market structure, state level reimbursement policies, nursing home level strategic decisions, and patient level characteristics such as insurance coverage disparities, minority status and low education levels. The Separate & Unequal project, headed by Mary Fennell, PhD, seeks to untangle the effects of these various factors on nursing access and quality of care.
Building upon our previous work detailing the poorer quality care in Black nursing homes, we have presented descriptive analyses of nursing home use by elderly Latinos from 2000-2005, and we have compared nursing home performance levels (using OSCAR measures) between facilities with different proportions of nursing home residents. Our results suggest that Latino/White comparisons on nursing home use are surprisingly similar to recent comparisons of black/white nursing home residents. The number of Latino elderly residing in nursing homes has grown over this period, and there is considerable geographic variability in Latino use rates. Also similar to black/white comparisons, elderly Latinos are more likely than whites to reside in nursing homes of poor quality.
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