Abstract
OBJECTIVE: To examine factors that might predict the provision of HIV/AIDS care among California nursing facilities (NFs) in 1990. STUDY DESIGN: Logistic regression to examine the probability that a NF had admitted a person with AIDS/HIV (PWA/H). Independent variables of key interest included whether the facility was hospital-based; whether it sustained a financial loss in FY 1990; whether it had a hospice; the percentage of its residents on Medicare; the percentage of its residents on MediCal; the number of PWA/Hs per elderly in the county where the facility was located; the ratio of home-based hospices to elderly in the county; and the ratio of NF beds to elderly in the county. DATA COLLECTION METHODS: Data on all California NFs, obtained from the Office of Statewide Health Planning and Development (OSHPD), were merged with state data on the cumulative incidence of AIDS cases by county; U.S. census data on the number of elderly by county; and home-based hospice data from the 1990 Case Management Resource Guide for California. PRINCIPAL FINDINGS: Of the 902 facilities examined, 7.65 percent served AIDS residents. The financial loss variable was not significant. The community-based hospice variable was significant and negative. All other key variables were significant and positive. CONCLUSIONS: This study (1) suggests that NFs respond to external pressures to provide AIDS care even in the absence of financial incentives or a positive financial margin; (2) supports concerns that competition may exist between the elderly and PWA/H for NF beds; (3) shows that NFs are less likely to provide care if substitute services are available; and (4) demonstrates that facilities capable of providing a higher level of clinical and psychosocial care may be particularly willing, perhaps able, to provide AIDS care.
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- Coll K. Specialized beds program: diversification options in skilled nursing facilities. QRB Qual Rev Bull. 1986 Apr;12(4):127–130. doi: 10.1016/s0097-5990(16)30026-4. [DOI] [PubMed] [Google Scholar]
- Gentry D., Fogarty T. E., Lehrman S. Providing long-term care for persons with AIDS. Results from a survey of nursing homes in the United States. AIDS Patient Care. 1994 Jun;8(3):130–137. doi: 10.1089/apc.1994.8.130. [DOI] [PubMed] [Google Scholar]
- Kator M. J., McBride L. C. Developing a long term care facility program for AIDS patients. Pride Inst J Long Term Home Health Care. 1990 Winter;9(1):15–19. [PubMed] [Google Scholar]
- Mason K. Caring for people with AIDS. Provider. 1992 May;18(5):30-2, 34, 36 passim. [PubMed] [Google Scholar]
- McCormick W. C., Inui T. S., Deyo R. A., Wood R. W. Long-term care needs of hospitalized persons with AIDS: a prospective cohort study. J Gen Intern Med. 1991 Jan-Feb;6(1):27–34. doi: 10.1007/BF02599386. [DOI] [PubMed] [Google Scholar]
- Shaughnessy P. W., Kramer A. M. The increased needs of patients in nursing homes and patients receiving home health care. N Engl J Med. 1990 Jan 4;322(1):21–27. doi: 10.1056/NEJM199001043220105. [DOI] [PubMed] [Google Scholar]
- Swan J. H., Benjamin A. E., Brown A. Skilled nursing facility care for persons with AIDS: comparison with other patients. Am J Public Health. 1992 Mar;82(3):453–455. doi: 10.2105/ajph.82.3.453. [DOI] [PMC free article] [PubMed] [Google Scholar]
- White C. M., Berger M. C. Response of hospitals, skilled nursing facilities, and home health agencies in Oregon to AIDS: reports of nursing executives. Am J Public Health. 1991 Apr;81(4):495–496. doi: 10.2105/ajph.81.4.495. [DOI] [PMC free article] [PubMed] [Google Scholar]