Use of gastrointestinal drugs was higher for residents with nursing home stays than those with assisted living stays (79% vs. The most prevalent drugs taken by residents in either setting were analgesics and antipyretics (82% NF vs. Having Medicare supplemental coverage (especially private) is associated with mean monthly drug use in the assisted living facilities but not in nursing homes. Beneficiaries whose institutional stay was paid for at least partially by Medicare have higher than average monthly prescription use (nine in NF, ten in ALF). Regularly scheduled medications comprised most drug regimens although drugs administered on an "as needed" basis were common (73% of NF residents vs. Virtually all beneficiaries in facilities used some medications, and mean monthly use is eight prescriptions. In 1998, approximately 1.9 million Medicare beneficiaries lived in a nursing facility (NF) during the year and about 640,000 resided in assisted living and related facilities (ALF). The study sample comprised 1,182 institutionalized beneficiaries with medication records. The institutional drug use file contains chart abstracts of medications prescribed or administered to residents while institutionalized. The MCBS facility file captures a comprehensive picture of Medicare beneficiaries residing in institutions. MethodsÄata are from the 1998 Medicare Current Beneficiary Survey (MCBS) facility and institutional drug files. Characteristics of institutionalized beneficiaries include demographics, income, regional residence, Medicare supplemental coverage, any community residence or skilled-nursing stays, death, health status, activities of daily living scores, and major medical conditions. Descriptions of medication use include mean number of drug mentions per month of stay (scheduled and PRN drugs), and prevalence and duration of therapy by major drug classes. This report compares the medication use of Medicare beneficiaries living in nursing homes and assisted living facilities. TABLE OF CONTENTS ABSTRACT INTRODUCTION METHODS STUDY FINDINGS CONCLUSIONS REFERENCES APPENDIX LIST OF TABLES TABLE 1: Institutional Medicare Beneficiaries by Type of Facility Stay and Resident Characteristics, 1998 TABLE 2: Institutional Medicare Beneficiaries by Type of Facility Stay and Resident Health Status, 1998 TABLE 3: Mean Number of Drug Mentions per Month for Institutionalized Medicare Beneficiaries by Type of Facility Stay, 1998 TABLE 4: Frequency Distribution of Mean Number of Drug Mentions per Month for Institutionalized Medicare Beneficiaries by Type of Facility Stay, 1998 TABLE 5: Mean Number of Drug Mentions per Month for Institutionalized Medicare Beneficiaries by Type of Facility Stay and Health Insurance Coverage, 1998 TABLE 6: Prevalence and Duration of Drugs Used by Medicare Beneficiaries in Nursing Facilities and Assisted Living and Related Facilities by Descending Order of Prevalence of Drug Class in Nursing Facilities, 1998 TABLE A1: Distribution of Beneficiaries in the 1998 MCBS Facility Sample with Institutional Drug Administrations by Type of Facility Stay TABLE A2: Characteristics of Facilities from which Residents Sampled ABSTRACT Objectives They do not necessarily reflect the views of the Department of Health and Human Services, the contractor or any other funding organization. The opinions and views expressed in this report are those of the authors. The e-mail address is: The Project Officer was Andreas Frank. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. For additional information about this subject, you can visit the DALTCP home page at or contact the office at HHS/ASPE/DALTCP, Room 424E, H.H. Department of Health and Human Services (HHS), Office of Disability, Aging and Long-Term Care Policy (DALTCP) and the University of Maryland. This report was prepared under contract #HHS-100-01-0023 between the U.S. Department of Health and Human Services Medication Use by Medicare Beneficiaries Living in Nursing Homes and Assisted Living Facilities Becky Briesacher, Bruce Stuart and Jalpa Doshi University of Maryland, Peter Lamy Center June 5, 2002
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