Minority disparities in disability between medicare beneficiaries
Minority disparities in disability between medicare beneficiaries
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DOI：
10.1111/j.1532-5415.2007.01570.x
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发表时间：
2008-03-01
影响因子：
6.3
通讯作者：
Chan, Leighton
中科院分区：
文献类型：
--
作者：
Ciol, Marcia A.;Shumway-Cook, Anne;Chan, Leighton
目的：调查参加 Medicare 的老年人在行动受限、日常生活活动 (ADL) 和日常生活工具性活动 (IADL) 方面的种族和民族差异。设计：纵向全国调查。参与者：1992 年至 2004 年 Medicare 当前受益人调查中的社区居住受访者（每组 10,180-16,788 名受访者）年）。测量：与残疾相关的结果包括行动受限、六项 ADL 和六项 IADL 的困难。解释变量包括年龄、性别、种族或民族、生活状况和收入水平。 结果：从 1992 年到 2004 年，不同种族和民族中行动受限的 Medicare 受益人比例保持稳定，ADL 和 IADL 略有改善。黑人报告说，所有三项与残疾相关的措施都受到更多限制。在纵向分析中，在调整年龄、性别、社会经济地位和生活状况后，黑人出现行动不便的可能性始终较高，其次是西班牙裔白人、非西班牙裔白人和亚洲人。对于 ADL 和 IADL 困难，所有民族和种族群体报告的困难数量随着年龄的增长而增加。在大约 75 岁的时候，亚洲人和西班牙裔白人报告称存在困难，其 ADL 和 IADL 数量远高于其他群体。结论：在所有民族和种族群体中，自我报告的残疾在过去十年中都有所下降，但即使在调整了年龄、性别、社会经济地位和生活状况后，残疾结果的种族和民族差异仍然存在。种族和民族可能会影响残疾的报告，并可能影响患病率的衡量。需要进一步的研究来了解这些差异是否是与残疾相关的看法的结果，还是种族和族裔群体之间残疾的真正差异。
OBJECTIVES: To examine racial and ethnic disparities in mobility limitation, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) in older adults enrolled in Medicare.DESIGN: Longitudinal national survey.PARTICIPANTS: Community-dwelling respondents in the Medicare Current Beneficiaries Survey from 1992 to 2004 (10,180-16,788 respondents per year).MEASUREMENTS: Disability-related outcomes included mobility limitation, difficulty in six ADLs and six IADLs. Explanatory variables included age, sex, racial or ethnic group, living situation, and income level.RESULTS: From 1992 to 2004, proportions of Medicare beneficiaries with mobility limitations were stable across racial and ethnic groups, improving slightly for ADLs and IADLs. Blacks reported more limitations in all three disability-related measures. In a longitudinal analysis, the probability of developing mobility limitation was consistently higher for blacks, followed by white Hispanics, white non-Hispanics, and Asians, after adjusting for age, sex, socioeconomic status, and living situation. For ADL and IADL difficulties, the number of reported difficulties increased with age for all ethnic and racial groups. At approximately age 75, Asians and white Hispanics reported difficulties with much higher numbers of ADLs and IADLs than the other groups.CONCLUSION: Across all ethnic and racial groups, self-reported disability has declined in the past decade, but even after adjusting for age, sex, socioeconomic status, and living situation, racial and ethnic disparities in disability outcomes persist. Race and ethnicity may influence the reporting of disability, potentially affecting measures of prevalence. Further research is needed to understand whether these differences are a result of perceptions related to disablement or true differences in disability between racial and ethnic groups.