Disability Patterns For Us Elderly Nursing Home Residents Over Two Decades: Findings From The 1973 To 1997 National Nursing Home Surveys

Older Americans are delaying and decreasing nursing home use over the past two decades (Bishop 1999). As a result, the elderly nursing home population has become older and more disabled. According to findings from recent national nursing home surveys (NNHS), the disability characteristics of the nursing home residents (NHR), mainly measured by functional status and primary diagnosis, have changed significantly over the past two decades (Kramarow et al. 1999). However, looking at variables in the surveys individually is unlikely to generate a complete description of the disability changes. This requires a multivariate approach which jointly investigates a range of disease and functional attributes. A good understanding of such changes is essential for health services research and related policymaking.

Previous studies using multivariate approaches (e.g., Corder and Manton 1996; Manton, Cornelius, and Woodbury 1995) were limited to short spans of time, providing little infor- mation on changes over time in important aspects of disability. The present study includes information obtained from four waves of the NNHS for years 1973, 1985, 1995, and 1997 to depict longer-term trends in the disability characteristics of elderly NHR: (1) Disease and impairment measures were used to identify impairment groups defining a general hier- archy of disability; (2) Prevalence of each group among residents was calculated for each survey year and compared overtime; and (3) Nursing home use for each level of disability was estimated.