Nursing Home–Based Care for Children Younger Than 18 Years: 2012–2019

OBJECTIVES We examined nursing home use from 2012 to 2019 by children younger than 18 years and evaluated disparities in short-term stays (≤100 days) and long-term care nursing home stays across racial and ethnic groups. METHODS We categorized children into 5 groups: non-Hispanic white (NHW), non-Hispanic Black (NHB), Asian, Hispanic, and an “Other” group, which included American Indian or Alaska Native, Native Hawaiian or Pacific Islander, multiracial or multiethnic children, and children with unknown race or ethnicity. To examine changes in the total number of short-term and long-term nursing home stays among children, we aggregated the number of stays by year and used negative binomial regression models to assess the yearly trends. RESULTS From 2012 to 2019, there were 22 351 nursing home stays by children younger than 18 years, of which 50.4% were by NHW children, 23.2% were by NHB children, 15.4% were by Hispanic children, 4.4% were by Asian children, and 6.7% were by children in the Other racial and ethnic group. Nursing home use among children declined over the study period for both short- and long-term stays. The proportion of NHW children decreased in both types of stays, whereas the proportions of NHB and those in the Other racial and ethnic category increased. CONCLUSION Together, the findings suggest a worsening racial disparity in care delivery for medically complex children. Research to understand the causes of these shifts, such as changes in the demographics of the population at risk, access to care, or treatment preferences, is urgently needed.