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Nursing home admissions for persons with dementia: Role of home‐ and community‐based services
Sijiu Wang, Di Yan, Helena Temkin‐Greener, Shubing Cai. Health Services Research, 2021-08-11
Topic: Risk, prevention and care in population studies
Considerable variations of breadth and intensity in county-level HCBS were observed. We found that a 10-percentage-point increase in HCBS breadth was associated with a 1.4 (p < 0.01)-percentage-point reduction in the likelihood of NH admission. Among individuals with NH admission, greater HCBS breadth was associated with a higher level of physical impairment, and greater HCBS intensity was associated with a higher level of physical and cognitive impairment at NH admission. Among community-dwelling duals with ADRD, Medicaid HCBS generosity was associated with a lower likelihood of NH admission and greater functional impairment at NH admission.
Key findings
- Considerable variations of breadth and intensity in county-level HCBS were observed.
- We found that a 10-percentage-point increase in HCBS breadth was associated with a 1.4 (p < 0.01)-percentage-point reduction in the likelihood of NH admission.
- Among individuals with NH admission, greater HCBS breadth was associated with a higher level of physical impairment, and greater HCBS intensity was associated with a higher level of physical and cognitive impairment at NH admission.
- Among community-dwelling duals with ADRD, Medicaid HCBS generosity was associated with a lower likelihood of NH admission and greater functional impairment at NH admission.
Why it matters
This study found that greater availability of home- and community-based services was associated with a lower likelihood of nursing home admission for people with dementia. It suggests that these services may help people with dementia stay in the community, but it does not address curing or preventing the disease.
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Study details
- Participants365,310
- Evidence strengthLow
How this study scored 50/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Health Services Research) |
| Journal's citation record | 2 / 4 | Health Services Research: journal h-index 166 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 4 / 4 | 365,310 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 32 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.6 citations a year over 7 year(s) since 2021 |
| Impact for its field and year | 3 / 6 | Cited 5.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 2 / 4 | Cited 18 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Shubing Cai: h-index 21 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Chicago: institution h-index 1,769 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 34382208) |
| Free to read | 2 / 2 | Free to read |
| Total | 50 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Wang, S., Yan, D., Temkin‐Greener, H., & Cai, S. (2021). Nursing home admissions for persons with dementia: Role of home‐ and community‐based services. Health Services Research. https://doi.org/10.1111/1475-6773.13715
Vancouver
Wang S, Yan D, Temkin‐Greener H, Cai S. Nursing home admissions for persons with dementia: Role of home‐ and community‐based services. Health Services Research. 2021. doi:10.1111/1475-6773.13715. PMID: 34382208.
BibTeX
@article{wang2021-34382208,
author = {Wang, Sijiu and Yan, Di and Temkin‐Greener, Helena and Cai, Shubing},
title = {{Nursing home admissions for persons with dementia: Role of home‐ and community‐based services}},
journal = {Health Services Research},
year = {2021},
doi = {10.1111/1475-6773.13715},
pmid = {34382208},
url = {https://doi.org/10.1111/1475-6773.13715}
}
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