Dying in a Nursing Home

Abstract

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.