Abstract
ABSTRACT It is well known that life expectancy in nursing homes (NHs) is lower for older adults than those residing elsewhere. In this paper, we attempt to discover the exact extent of this loss of life expectancy, and whether it can be explained by pre-existing health state conditions, especially the seriousness of dementia. We use a parametric survival model, on a large data set spanning up to 13 years, which covers health states and types of residence for all time periods until a person dies. In the absence of health state controls, the loss of life expectancy is 47 months. Accounting for health states still leads to a 41-month loss of life. Even those with serious dementia would live longer lives if not residing in a NH. We then value the estimated loss of life years. The losses are large, equal to $1.7 million per NH resident, and $1.87 trillion for the US NH population.
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