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Correspondence: Address correspondence to Charles D. Phillips, Department of Health Policy and Management, School of Rural Public Health, Texas A & M University System Health Science Center, 3000 Briarcrest Drive, Suite 310, Bryan, TX 77802. E-mail: phillipscd{at}srph.tamushsc.edu
Purpose:Assisted living is an increasingly important residential setting for the frail elderly person. How often and why residents leave such facilities are important issues for consumers, for clinicians advising frail patients on their options for living arrangements, and for policymakers. This research investigated the impact of facility and individual characteristics on residents' departures from assisted living.Design and Methods:This research is based on data on 1,483 residents in a nationally representative sample of 278 assisted living facilities (ALFs). Analyses of these data from 1998 and 1999 especially focused on those residents who left a study ALF between baseline and follow-up data collection. Multinomial logit models were estimated to investigate the impact of facility and individual factors on residents' status at follow-up.Results:Over three quarters of those leaving their baseline ALF did so because they needed more care. The multivariate analyses indicated that poorer functional status and being married affected residents' relative odds of death before follow-up. Moving to another setting, other than a nursing home, was more likely for residents in for-profit ALFs. Functional status, cognitive status, and the presence of a full-time RN affected residents' odds of moving from an ALF to a nursing home.Implications:Both facility-level and individual-level factors affected residents' relative odds of leaving an ALF. The findings with the most potentially interesting policy implications are those concerning the factors that affected residents' relative likelihoods of entering a nursing home.
Key Words: Nursing homes • Nursing home placement • Assisted living • Housing with supportive services
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