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This version was published on February 1, 2008
Journal of Aging and Health, Vol. 20, No. 1, 66-88 (2008)
DOI: 10.1177/0898264307309935

Dying in a Nursing Home

The Role of Local Bed Supply in Nursing Home Discharges

Frederic H. Decker, PhD

National Center for Health Statistics, Hyattsville, Maryland

Objective: The relationship of nursing home (NH) discharges due to death to NH bed supply and hospital bed supply was examined. Method: Data on discharges came from the 1999 National Nursing Home Survey (N = 6,335). County-level bed supply, controls for hospice agency supply, and a nursing facility's percentage of area NH beds came from the Area Resource File. Multinomial logistic regression was used to compare deaths with live discharges. Marginal effects were calculated. Results: Discharges due to death increased with increasing NH bed supply and decreased in areas with greater hospital bed supply, areas where hospitalizations were more likely. Hospice supply and a facility's share of area NH beds also affected the probability of discharges due to death. Discussion: Supply factors appear related to discharge decisions in a manner affecting the probability of discharges due to death, although the magnitude of the relationship may be less than expected.

Key Words: nursing homes • death • discharges • bed supply • hospice


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