Medicaid community-based programs: A longitudinal analysis of state variation in expenditures and utilization
Medicaid community-based programs: A longitudinal analysis of state variation in expenditures and utilization
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DOI：
10.5034/inquiryjrnl_40.4.375
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发表时间：
2003-12-01
影响因子：
1.7
通讯作者：
Harrington, C
中科院分区：
文献类型：
--
作者：
Kitchener, M;Carrillo, H;Harrington, C
由于国家面临的挑战，预算危机和压力，以发展医疗补助家庭和社区为基础的服务（HCBS），本文提供了一个纵向分析的状态变化的支出和利用三个HCBS计划（豁免，家庭健康和个人护理），并为总医疗补助HCBS。分析的第一部分描述了1999年每个方案的州差异的性质和范围，使用了每千人参加人数和人均支出等措施。分析的第二部分提出了时间序列回归模型，估计社会人口，国家政策和市场因素与国内变化的豁免参与者和支出，家庭健康，个人护理和总HCBS支出为1992-99年期间。在这些结果中，与HCBS参与者和支出相关的州一级积极因素包括：老年人比例较高，人均收入较高，家庭保健机构供应量较大。
As states face challenges posed by budget crises and pressures to develop Medicaid home and community-based services (HCBS), this paper provides a longitudinal analysis of state variation in expenditures and utilization for three HCBS programs (waivers, home health and personal care), and for total Medicaid HCBS. The first part of the analysis describes the nature and scope of state variation for each program in 1999, using such measures as participants per 1,000 population and expenditures per capita. The second part of the analysis presents time-series regression models that estimate sociodemographic, state policy, and market factors associated with intra-state variation in waiver participants and expenditures, and home health, personal care and total HCBS expenditures for the period 1992-99. Among the results, positive state-level factors related to HCBS participants and expenditures include: higher percentages of aged people, greater incomes per capita, and a larger supply of home health agencies.