Trade-Offs Between Formal Home Health Care and Informal Family CareGiving
Trade-Offs Between Formal Home Health Care and Informal Family CareGiving
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DOI：
10.1023/b:jeei.0000039945.66633.ad
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发表时间：
2004-01
影响因子：
2.4
通讯作者：
S. White-Means;R. Rubin
中科院分区：
文献类型：
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作者：
S. White-Means;R. Rubin
使用1994年国家长期护理调查数据，我们估计正式和非正式的家庭卫生保健的使用和时间的逻辑回归。家庭医疗保健的使用和强度受到慢性病的不同影响，医疗补助注册者和农村或小城镇居民的家庭医疗保健使用和强度较高，但HMO注册者的家庭医疗保健使用和强度较低。家庭医疗保健使用的可能性减少，非正式工具性日常生活活动（IADL）支持4小时，非正式日常生活活动（ADL）支持每周8小时。IADL评分替代了正规护理，但ADL评分随着正规护理的减少而下降。公共政策减少正式的家庭卫生保健的访问可能会减少非正式的ADL的支持，并增加非正式的IADL的支持，产生净下降。
Using 1994 National Long Term Care Survey data, we estimated logistic regressions of formal and informal home health care use and hours. Home health care use and intensity were differentially impacted by chronic conditions, are higher for Medicaid enrollees and rural or small town residents, but lower for HMO enrollees. Decreases in the probability of home health care use increased informal instrumental activities of daily living (IADL) support four hours and decreased informal activities of daily living (ADL) support eight hours weekly. IADL caregiving substituted for formal care, but ADL caregiving declined with reductions in formal care. Public policy reducing formal home health care access may reduce informal ADL caregiving and increase informal IADL caregiving, producing net declines in support.