The Relationship between Older Americans Act Title III State Expenditures and Prevalence of Low‐Care Nursing Home Residents

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Abstract
Objective: To test the relationship between older Americans Act (OAA) program expenditures and the prevalence of low‐care residents in nursing homes (NHs).Data Sources and Collection: Two secondary data sources: State Program Reports (state expenditure data) and NH facility‐level data downloaded from LTCfocUS.org for 16,030 US NHs (2000–2009).Study Design: Using a two‐way fixed effects model, we examined the relationship between state spending on OAA services and the percentage of low‐care residents in NHs, controlling for facility characteristics, market characteristics, and secular trends.Principal Findings: Results indicate that increased spending on home‐delivered meals was associated with fewer residents in NHs with low‐care needs.Conclusions: States that have invested in their community‐based service networks, particularly home‐delivered meal programs, have proportionally fewer low‐care NH residents.

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