Working Paper: NBER ID: w17750
Authors: Frank R. Lichtenberg
Abstract: I examine the effect of pharmaceutical innovation on the functional status of nursing home residents using cross-sectional, patient-level data from the 2004 National Nursing Home Survey. This was the first public-use survey of nursing homes that contains detailed information about medication use, and it contains better data on functional status than previous surveys.\n\nResidents using newer medications and a higher proportion of priority-review medications were more able to perform all five activities of daily living (ADLs), controlling for age, sex, race, marital status, veteran status, where the resident lived prior to admission, primary diagnosis at the time of admission, up to 16 diagnoses at the time of the interview, sources of payment, and facility fixed effects. \n\nThe ability of nursing home residents to perform activities of daily living is positively related to the number of "new" (post-1990) medications they consume, but unrelated to the number of old medications they consume. If 2004 nursing home residents had used only old medications, the fraction of residents with all five ADL dependencies would have been 58%, instead of 50%. During the period 1990-2004, pharmaceutical innovation reduced the functional limitations of nursing home residents by between 1.2% and 2.1% per year.
Keywords: pharmaceutical innovation; functional limitations; elderly; nursing home survey
JEL Codes: I12; L65; O33
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Old medications (L65) | Fraction of residents with all five ADL dependencies (J14) |
| Pharmaceutical innovation (O35) | Improvements in functional status of nursing home residents (I14) |
| Newer medications (Y50) | Capability of performing activities of daily living (ADLs) (J14) |
| Priority-review medications (L65) | Capability of performing activities of daily living (ADLs) (J14) |
| Number of new post-1990 medications consumed (I12) | Ability to perform all five ADLs (J14) |