Service Use and Transitions: Decisions, Choices and Care Management among an Admissions Cohort of Privately Insured Disabled Elders. IV. FINDINGS


Figure 1 below shows the distribution of the admissions cohort sample in terms of service status at the baseline interview. Over one-third of the sample was using paid care at home at the time of the baseline interview. The smallest proportion was receiving care in nursing homes. About one quarter of the entire sample (26%) notified their insurance company of their intent to begin using paid services and file a claim, but had not yet started at the time of the baseline interview.


FIGURE 1: Distribution of Sample

Figure 2 shows the distribution of only those who were already using paid care at the time of the baseline interview. Of all individuals who contacted their insurance company with the intent to file a claim and who were already receiving paid services, half were living at home and the other half were in residential care settings (more in ALFs than in Nursing Homes). Across the participating companies there was a great deal of variation in the distribution of inquiries across service settings.

FIGURE 2: Distribution of Paid Care Receivers by Service Setting

Among those entering residential care settings, the percentage moving to ALFs very high, especially when one considers that such facilities developed only within the last 15 years. In a prior study of in-force claimants completed in the late 1990s, 27% of residential care claimants were residing in ALFs (Cohen, et al.1999 & 2000). How does the distribution of in-force residential care claimants, compare to this sample of newly admitted residential care claimants? Figure 3 suggests that the proportion of individuals accessing assisted living has significantly increased over the past 5-6 years. Whereas in the late 1990s 73% of residential care claimants were receiving care in nursing homes, by 2004, more than three in five individuals choosing residential care began their care in ALFs.3

FIGURE 3: Distribution of Newly Admitted and In-force Residential Care Claimants by Setting

In the analyses that follow, results are presented separately for each service setting (including in places, those who are not yet receiving paid care).

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