Huiwen Xu
Emory University, GA·Public Health & Epidemiology
Nursing homes care for many of the most vulnerable older adults in the United States, and the policies and care models they adopt have measurable effects on whether residents are hospitalized, develop pressure sores, lose physical function, or die. Two projects use large national health data linked to unusually detailed state-level data from Ohio to evaluate two specific features of nursing home care: specialized dementia units, and the visitation bans imposed during the 2020 infectious disease emergency.
- Fields
Public Health & Epidemiology
Medicine & Clinical Research
Social Science
- Topics
nursing homes
long-term care
Alzheimer's special care units
- Grants
- 2 known grants, through May 2028
What they work on
- Examine whether Black and Hispanic nursing home residents with dementia have less access to Alzheimer's special care units, using decomposition methods on Medicare claims and resident assessments for 819,415 newly admitted long-stay residents across 15,305 facilities.
- Test whether differences in special care unit access mediate racial and ethnic disparities in outcomes such as hospitalization and pressure ulcers, and use dominance analysis to rank which unit features — physical environment, staffing, physician involvement — drive outcomes and satisfaction.
- Identify which state policies, including supplementary payments for special care unit care, Medicaid payment-to-cost ratios, and staffing or training requirements, are associated with greater unit availability, using hierarchical generalized linear mixed models and difference-in-differences analysis.
- Assess whether visitation bans prevented infections, hospitalizations and deaths among nursing home residents, comparing 9,876 facilities in 31 states that banned and then lifted indoor visitation in 2020 with a matched case-control design on prior infection rates.
- Evaluate how visitation bans were associated with changes in physical function, mood and behavior, and adverse events among long-stay residents with and without dementia, using weekly facility-level ban data from 701 Ohio nursing homes.
- Describe how visitation bans altered daily care practices through focus groups with direct care staff and analysis of open-ended family comments from a statewide Ohio satisfaction survey.
More about the research
Both ask who benefits, who is harmed, and what state policy can change — with particular attention to residents who have Alzheimer's Disease and Related Dementias (ADRD) and to racial and ethnic differences in care.
Why it matters
State legislators and Medicaid agencies are actively deciding how to pay for dementia care units and whether to guarantee nursing home visitation rights, often without evidence. These analyses could show whether expanding access to Alzheimer's special care units would narrow gaps in hospitalization and pressure ulcers for Black and Hispanic residents, which unit features matter most, and whether visitation bans prevented enough infection to justify their costs to residents' function and mood — especially for residents with dementia.
Known grants
From NIH and NSF research grants. Labs often have other funding we can't see.
Closest labs
Rebecca Rodin
Icahn School of Medicine at Mount Sinai, NY·Public Health & Epidemiology
Compare changes in opioid use after the 2016 CDC guidelines between older adults with and without Alzheimer's disease and related dementias who have cancer or hip or pelvic fracture, using Medicare Current Beneficiary Survey data and a difference-in-differences design.
Krista Harrison
University of California-San Francisco, CA·Public Health & Epidemiology
Identify how Black, Latinx and Asian American care partners define high-quality end-of-life dementia care, through interviews with 90 people about hospice and other home-based supportive care.
Barbara Bates-Jensen
University of California-Los Angeles, CA·Medicine & Clinical Research
Test whether subepidermal moisture readings of residents' sacral and heel skin, taken during routine visual skin checks, effectively cue nursing staff to start standard pressure injury prevention in eight nursing homes.
The school
Emory University: 70 labs on PI Pages, $1.2B a year on research, 286 research doctorates a year.
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