{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T07:09:20Z","timestamp":1778742560485,"version":"3.51.4"},"reference-count":49,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,8,21]],"date-time":"2024-08-21T00:00:00Z","timestamp":1724198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,8,21]],"date-time":"2024-08-21T00:00:00Z","timestamp":1724198400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100012483","name":"University of Georgia Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To examine the relationship between living arrangements and discharge disposition, and how this relationship differs by the rural or urban characteristics of the patient's residence among home health care patients with Alzheimer's disease and related dementia (ADRD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study used the 2019 Outcome and Assessment Information Set and the Master Beneficiary Summary File. Our study was based on 531,269 Medicare fee\u2010for\u2010service patients with ADRD. We used linear probability regression models to examine the relationship between discharge disposition (to the community vs. an institution) and living arrangements, including an interaction term for rural\u2010urban residence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Patients in rural areas (19.8%) were more likely to live alone than those in urban areas (15.2%). Our main results show that patients living at home with others (coefficient: \u20130.02,\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value &lt; 0.001) or alone (coefficient: \u20130.03,\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value &lt; 0.001) were less likely to be discharged to the community compared to patients who lived in congregate settings. Also, for patients with ADRD who lived in rural areas, living at home with others (rural*home with others; coefficient: \u20130.02,\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value &lt; 0.001) or living alone (rural*home alone; coefficient: \u20130.03,\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value&lt;0.001) were associated with additional lower probabilities of being discharged to their communities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A multidimensional approach considering living arrangements to support home health care patients with ADRD could be critical to achieving better health outcomes. Furthermore, implementing area\u2010specific target interventions could be important for improving the care and health of patients with ADRD as well as reducing rural\u2010urban disparities in discharge disposition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jrh.12872","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:29:59Z","timestamp":1724286599000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Discharge disposition for home health care patients with Alzheimer's disease and related dementia: The role of living arrangements and rural living"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2872-0873","authenticated-orcid":false,"given":"Daniel","family":"Jung","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management College of Public Health University of Georgia  Athens Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeong","family":"Ha (Steph) Choi","sequence":"additional","affiliation":[{"name":"Department of Psychology College of Arts &amp; Sciences Georgia State University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerstin Gerst","family":"Emerson","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management College of Public Health University of Georgia  Athens Georgia USA"},{"name":"Institute of Gerontology University of Georgia  Athens Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/EURPUB\/CKV052"},{"issue":"537","key":"e_1_2_9_3_1","first-page":"271","article-title":"Health risk appraisal in older people 1: are older people living alone an \u2018at\u2010risk\u2019 group?","volume":"57","author":"Kharicha K","year":"2007","journal-title":"British J Gen Pract"},{"key":"e_1_2_9_4_1","volume-title":"Health Care Comes Home: The Human Factors","author":"National Research Council","year":"2011"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20108223(02)90185\u20109"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1377\/HLTHAFF.2018.05409"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.13573"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JALZ.2011.03.005"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ALZ.12438"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JALZ.2019.01.010"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S104161021000013X"},{"key":"e_1_2_9_12_1","first-page":"361","volume-title":"The Routledge Handbook of Health Communication","author":"Goldsmith DJ"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jurban\/78.3.458"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643\u2010017\u20100632\u20102"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.COPSYC.2021.08.027"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3934\/PUBLICHEALTH.2020042"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1353\/pbm.2003.0049"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0959259800104101"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.572583"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/S12929\u2010018\u20100404\u2010X"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/JRH.12415"},{"issue":"5","key":"e_1_2_9_22_1","first-page":"363","article-title":"Addressing rural health challenges head on","volume":"114","author":"Nielsen M","year":"2017","journal-title":"Mo Med"},{"key":"e_1_2_9_23_1","unstructured":"TaylorLA.Housing and health: an overview of the literature.2018. doi:10.1377\/hpb20180313.396577Published online June 7 2018"},{"key":"e_1_2_9_24_1","unstructured":"United States Interagency Council on Homelessness.ALL IN: The Federal Strategic Plan to Prevent and End Homelessness.2022."},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/JRH.12535"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010022\u201003247\u20105"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621424.2012.703908"},{"key":"e_1_2_9_28_1","unstructured":"MartinoSC ElliottMN DemboskyJ et al.Rural\u2010Urban Disparities in Health Care in Medicare.;2020. 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