Estimating paid and unpaid hours of personal assistance services in activities of daily living provided to adults living at home
Estimating paid and unpaid hours of personal assistance services in activities of daily living provided to adults living at home
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DOI：
10.1111/1475-6773.029
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发表时间：
2002-04-01
影响因子：
3.4
通讯作者：
Kang, TW
中科院分区：
文献类型：
--
作者：
LaPlante, MP;Harrington, C;Kang, TW
客观的。使用具有全国代表性的家庭调查数据来估计向美国家庭中的成年人提供的有偿和无偿个人日常生活援助的总小时数。数据来源。 1994 年至 1997 年进行的全国残疾健康访谈调查 (NHIS-D) 的残疾追踪调查。数据收集/提取方法。获得了接受最多 5 个 ADL 和 10 个 LAMB 帮助的人的数据，最多有 4 名帮助者，包括他们帮助的活动、帮助者是否有报酬，以及调查前两周内提供帮助的小时数。该样本由 8,471 名 18 岁及以上接受个人协助的家庭居民成年人组成。大约 22% 的样本缺少小时数数据，我们使用人口统计、ADL 和 IADL 变量通过多重回归模型进行估算。结果。我们估计，1320 万非收容成年人平均每周接受 31.4 小时的 ADL 和 IADL 个人援助，其中 320 万人平均接受 17.6 小时的有偿帮助，1170 万人平均接受 30.7 小时的无薪帮助。 18-64 岁的人比 65 岁及以上的人接受帮助的人数更多（6.9 比 620 万人），但工作年龄接受者每周的工作时间较少（27.4 比 35.9），部分原因是残疾程度较轻。结论。每年向成年残疾人提供的个人援助总计达 215 亿小时，1996 年经济价值接近 2000 亿美元。其中只有 16% 得到支付，相当于每年家庭健康服务支出 320 亿美元。这项研究首次对工作年龄和老年人的援助时间进行了估算，研究表明，老年人更有可能获得有偿个人援助，而工作年龄的人则更大程度地依赖无偿帮助。这项研究开始阐明提供个人援助的分工。按 ADL 数量估算的带薪和无薪帮助时间应为有关长期护理资格界限的政策提供依据。
Objective. To estimate the total hours of paid and unpaid personal assistance of daily living provided to adults living at home in the United States using nationally representative household survey data.Data Sources. The Disability Followback Survey of the National Health Interview Survey on Disability (NHIS-D) conducted from 1994 to 1997.Data Collection/Extraction Methods. Data were obtained on persons receiving help with up to 5 ADLs and 10 LAMB, for up to 4 helpers, including the activities they helped with, whether the helper was paid or not, and the number of hours of help provided in the two weeks prior to the survey. The sample consists of 8,471 household-resident adults ages 18 and older receiving help with personal assistance. About 22 percent of the sample has missing data on hours, which we impute by multiple regression models using demographic, ADL, and IADL variables.Findings. We estimate that 13.2 million noninstitutionalized adults receive an average of 31.4 hours per week of personal assistance in ADLs and IADLs per week, with 3.2 million people receiving an average of 17.6 hours of paid help and 11.7 million receiving an average of 30.7 hours of unpaid help. More persons ages 18-64 received help than those ages 65 and older (6.9 versus 6.2 million), but working-age recipients had fewer hours (27.4 versus 35.9) per week, due in part to less severe levels of disability.Conclusions. Personal assistance provided to adults with disabilities amounts to 21.5 billion hours of help per year, with an economic value in 1996 approaching $200 billion. Only 16 percent of this total is paid, representing $32 billion in home health services spent annually. This study, the first to estimate hours of assistance for both working-age and older adults, documents that older persons are more likely to receive paid personal assistance, while working-age people rely to a greater extent on unpaid help. This study begins to articulate the division of labor in the provision of personal assistance. Estimates of paid and unpaid hours of help by number of ADLs should inform policy concerning eligibility boundaries in long term care.