PROVIDENCE, R.I. [Brown University] The more states spend on home-delivered meals under the Older Americans Act, the more likely they are to help people who don't need nursing home care to stay in their homes, according to a newly published Brown University statistical analysis of a decade of spending and nursing home resident data.
"Despite efforts to rebalance long-term care, there are still many nursing home residents who have the functional capacity to live in a less restrictive environment," wrote gerontology researchers Kali Thomas and Vincent Mor in the article published online Dec. 3 in the journal Health Services Research. "States that have invested in their community-based service networks, particularly home-delivered meals, have proportionally fewer of these people than do those states that have not."
Nationwide in 2009, 12.6 percent of nursing home residents were considered "low-care," meaning they did not need much of the suite of services that a nursing home provides. That proportion had declined from 17.9 percent in 2000 because of a variety of efforts, including OAA programs as well as Medicaid-sponsored home- and community-based services (HCBS).
But the percentages every year vary widely between the states. A major reason for that state-to-state variation turns out to be the difference that home-delivered meals can make. The researchers wrote that their analysis boils down to this ratio: For every $25 per year per older adult above the national average that states spend on home-delivered meals, they could reduce their percentage of low-care nursing home residents compared to the national average by 1 percentage point.
Thomas and Mor's calculations didn't merely associate each state's meals spending with its percentage of low-care residents in nursing homes. They also statistically controlled for the overall decline over time and a wide variety of factors that might also have affected the rates. Those
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