Driven to tiers: Socioeconomic and racial disparities in the quality of nursing home care

Vincent Mor, Jacqueline Zinn, Joseph Angelelli, Joan Teno, Susan C. Miller

Research output: Contribution to journalArticle

251 Citations (Scopus)

Abstract

Nursing home care is currently a two-tiered system. The lower tier consists of facilities housing mainly Medicaid residents and, as a result, has very limited resources. The nearly 15 percent of U.S. nonhospital-based nursing homes that serve predominantly Medicaid residents have fewer nurses, lower occupancy rates, and more health-related deficiencies. They are more likely to be terminated from the Medicaid/Medicare program, are disproportionately located in the poorest counties, and are more likely to serve African-American residents than are other facilities. The public reporting of quality indicators, intended to improve quality through market mechanisms, may result in driving poor homes out of business and will disproportionately affect nonwhite residents living in poor communities. This article recommends a proactive policy stance to mitigate these consequences of quality competition.

Original languageEnglish (US)
Pages (from-to)227-256
Number of pages30
JournalMilbank Quarterly
Volume82
Issue number2
DOIs
StatePublished - Aug 10 2004
Externally publishedYes

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Medicaid
Home Care Services
Nursing Care
Nursing Homes
Medicare
African Americans
Nurses
Health

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Driven to tiers : Socioeconomic and racial disparities in the quality of nursing home care. / Mor, Vincent; Zinn, Jacqueline; Angelelli, Joseph; Teno, Joan; Miller, Susan C.

In: Milbank Quarterly, Vol. 82, No. 2, 10.08.2004, p. 227-256.

Research output: Contribution to journalArticle

Mor, Vincent ; Zinn, Jacqueline ; Angelelli, Joseph ; Teno, Joan ; Miller, Susan C. / Driven to tiers : Socioeconomic and racial disparities in the quality of nursing home care. In: Milbank Quarterly. 2004 ; Vol. 82, No. 2. pp. 227-256.
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