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

The purpose of this study is to obtain a comprehensive demographic, health and attitudinal profile of individuals with private long-term care (LTC) insurance policies at the time that they begin using paid LTC services in their current service setting. The authors also seek to understand the factors involved in the decision about how and why to use paid services in particular care settings (i.e., the home, assisted living or nursing facilities). Equally important, the authors wish to understand how and why people transition between care settings throughout the course of their disability and also assess the role of care management in the process. In order to do this, the authors focused on an admissions cohort of LTC claimants and traced their experience and service utilization over time and in multiple settings. That is, they completed in-person interviews with LTC insurance policy holders at or near the time they began using paid services (in either a residential care setting or the community) and then followed them telephonically over a roughly two year period. For the purposes of this report, the authors only discuss findings from the initial in-person interviews. [61 PDF pages]