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Policy Determinants of Medicaid Nursing Home Use in Pennsylvania, 2013-2019

Da Costa, Damian (2023) Policy Determinants of Medicaid Nursing Home Use in Pennsylvania, 2013-2019. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

This dissertation applies statistical modeling techniques to estimate the impact of policy determinants on nursing home use in the Medicaid-covered population in Pennsylvania during the years 2013-2019. Using difference-in-difference analysis, the first essay exploits Pennsylvania’s staggered implementation of mandatory managed care to investigate whether longstay (>100 day) nursing home residents in counties that moved to managed care were more likely to be successfully discharged to a community setting within six months of longstay incidence. The second essay models the association between regional subsidized housing access and discharge to a community setting among longstay nursing facility residents. The third essay uses probabilistic matching to assign HUD program status (public housing, Section 8 project-based, and Section 202) to a population of waiver-eligible Pennsylvania Medicaid enrollees. Time-to-event analysis is applied to compare hazard of nursing home admission among these three housing-defined Medicaid populations.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Da Costa, Damiandamian.dacosta@gmail.comdrd42
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairDegenholtz, Howardhoward.degenholtz@pitt.eduhoward.degenholtz
Committee MemberRoberts, Ericeric.roberts@pitt.edueric.roberts
Committee MemberAlbert, Stevensmalbert@pitt.edusmalbert
Committee MemberCohen, Marcmarc.cohen@umb.edu
Date: 3 January 2023
Date Type: Publication
Defense Date: 15 December 2022
Approval Date: 3 January 2023
Submission Date: 16 December 2022
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 99
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Health Policy & Management
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: long-term care, medicaid, nursing homes, skilled nursing facilities, hcbs, hud, housing policy, section 202, difference-in-differences, survival analysis
Date Deposited: 03 Jan 2023 15:11
Last Modified: 03 Jan 2023 15:11
URI: http://d-scholarship.pitt.edu/id/eprint/44050

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