Defining nursing home markets from a consumer perspective

The purpose of this study was to examine the nursing home market, to evaluate whether population density, admission source, and primary contact gender (son or daughter) help predict the selection of a nursing home. Proprietary archival data from a large healthcare system was used for this study, which represented initial admissions for 42,021 residents to one of 98 nursing home facilities between 2010 and 2013, from five sources: assisted living facilities, hospitals, other nursing homes, primary residences, or other sources. Key variables included demographic information, as well as the residents' past primary residence address, primary contacts' address, and admission source address. This research contributes several important findings. First, a practically and statistically significant amount of variance (15%) is accounted for by population density in distance from primary residence to the nursing home; beyond that, a nursing home admissions source does not add practical value to our ability to predict this distance. Second, a significantly greater distance from primary contact residence as compared to the distance from primary residence to the nursing home suggests that a nursing home is often chosen to be in closer proximity to the residents' past primary residence than to the home of the residents' primary contacts. Third, distance from primary contact residence was shorter when the primary contact was a daughter, as compared to a son. These findings are important because nationwide most nursing home admissions (78%) come from an acute care setting. Proximity to the nursing home facility is a criteria used in healthcare decisions, therefore, a more detailed conceptualization of distance from primary residence and primary contact residence variables enhances researchers' and policy makers' knowledge and ability to predict the market for nursing home facilities.