What Factors Influence the Kind of Long-Term Services Patients with Private Insurance Choose Over Time

Decisions, choices, and care management among an admission cohort of privately insured disabled elders

Researchers with the Center for Health and Long-Term Care Research, Waltham, Mass., interviewed 1,474 individuals with long-term care insurance policies and followed them for up to two years.

The goal was to examine the factors that influence the kind of long-term services patients choose over time, including:

  • Paid care at home.
  • Assisted-living facilities.
  • Nursing homes.

Key Findings:

  • At the time of the initial interviews:
    • 37 percent of respondents were receiving paid care at home.
    • 14 percent of respondents were newly admitted to nursing homes.
    • 23 percent of respondents were newly admitted to assisted-living facilities.
    • 26 percent of respondents expected to begin receiving paid services in the next two months.
  • Respondents in all service settings ranked "having someone available to assist when needed" as the most important consideration in choosing where to receive care. "Feeling safe" was the next most important consideration.
  • Some 93 percent of home-care recipients said that such care was their first choice.
  • Nearly three-quarters (71%) of nursing home residents indicated that there were no other options for long-term care in their area.