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Research on Aging
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Long-Term Care Case Managers’ Out-of-Home Placement Decisions

An Application of Hierarchical Logistic Regression

Howard B. Degenholtz

University of Pittsburgh

Rosalie A. Kane

University of Minnesota

Robert L. Kane

University of Minnesota

Michael D. Finch

United Health Care

Hierarchical logistic regression was used with the results of a factorial vignette survey of a national sample of case managers for the disabled elderly in Medicaid home- and community-based services waiver programs. The effects of client, case manager, and agency factors on case managers’out-of-home placement decisions in response to hypothetical case studies were estimated. Results show that client preferences, workload, and division of labor affect the probability that a case manager will recommend an out-of-home placement, controlling for client’s physical and cognitive disability and the available resources. Significant variation among individuals was found. Implications of the findings are discussed.

Research on Aging, Vol. 21, No. 2, 240-274 (1999)
DOI: 10.1177/0164027599212005
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