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Guest post: Health care reform and nursing homes

Posted Nov 30 2009 10:00pm

This is a guest post by Denise Tyler, PhD, an Investigator in the Center for Gerontology & Health Care Research at Brown University.  She is the project manager for the Shaping Long-Term Care in America Project, a five-year, $10 million project funded by the National Institute on Aging that aims to improve nursing home care in the US by examining how market factors and state policies affect the quality of care delivered in the country’s 15,000+ nursing homes.

Millions of Americans live in nursing homes and millions more receive short-term care from one after a hospital stay.  But the current health care reform debate has largely ignored nursing home care.

This is due, in part, to a lack of data about how and why that care is given.

As we move ahead with health care reform, we must understand how nursing homes are being utilized, what kinds of patients live in them, and what the outcomes are for the people who rely on them for care.

This matters because health care reform will likely be paid for in large part, by reductions in current health care spending.  And the majority of these reductions will come from the Medicare program and nursing homes will likely be the target of these spending reductions.

Until now, there has been no resource for accessing information about nursing homes and those they care for.  A new Web site that provides this information for the first time, www.LTCfocUS.org, has been developed by the Center for Gerontology and Healthcare Research at Brown University.

LTCfocUS.org hosts data regarding the health and status of nursing home residents, characteristics of care facilities, and state policies relevant to long term care services and financing.  The Web site allows policy makers and researchers to trace clear relationships between state policies and local market forces and the quality of nursing home care. What’s more, www.LTCfocUS.org also provides information gathered from a variety of sources, which makes it useful to answer research and policy relevant questions that could not previously have been answered.  For example, the Web site can be used to determine which nursing homes are providing greater proportions of Medicare services or examine the growth in Medicare services in nursing homes over time.

The Web site contains data about nursing home resident health, with specific information covering areas including incontinence, or the number of patients who are on anti-depressants or have high blood pressure.  Users can also learn about the size of nursing home facilities, whether they are for profit or non-profit or affiliated with a chain. Do you want to know how full these facilities are? Our Web site can also help with this information.

The system now in place can also inform about local market condition and competition, the Medicare Managed Care market penetration rate, and state policies regarding Medicaid spending on nursing homes.

In addition, because the Web site provides several years of data, it is possible to examine trends over time and determine how changes in nursing home policy or financing have affected nursing homes and their residents from year to year.  This information will be important for deciding which policies and financing schemes improve care and save money, some of the primary goals of healthcare reform.

Why is this information necessary? It matters in the bigger picture, for both health care and health care reform.

Health care reform will spur many changes and it is critical that these changes be evidence-based, and not dependent on politics. LTCfocUS.org is a new resource that will be vital to building this evidence base regarding nursing home care.

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