Paying the Price: The Cost of Caregiving for Older Latinos Enrolled in Medicare and Medicaid.
Paying the Price: The Cost of Caregiving for Older Latinos Enrolled in Medicare and Medicaid.
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付出代价：参加医疗保险和医疗补助的老年拉丁美洲人的护理成本。
DOI：
10.1093/ppar/prad032
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Angel,Jacqueline
中科院分区：
文献类型：
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作者：
Antequera,Felipe;Rote,Sunshine;Cantu,Phillip;Angel,Jacqueline
众多的社会和人口因素，包括婚姻破裂率高、初次生育年龄大和总生育率低，导致了美国世纪平均家庭规模的下降。虽然墨西哥裔美国人的子女继续多于非西班牙裔美国人，但他们的平均家庭规模有所减少，这在未来几年可能会继续下去（Angel & Angel，2009年）。在家庭变小的同时，寿命却大幅增加，尤其是墨西哥裔美国人，他们出生时和老年时的预期寿命比非洲裔美国人或欧洲裔美国人长（阿里亚斯和Xu，2022年）。其结果是老年受抚养人比率不断增加，这对墨西哥裔美国人家庭和各级政府的社会政策构成了潜在的严重挑战（Angel等人，2004年）。更长的寿命显然是可取的，特别是如果一个人在额外的几年里身体健康（Angel等人，2015年）。不幸的是，以前的研究表明，发病率没有得到显着压缩，越来越多的墨西哥裔美国人社区，家庭和护理系统将面临来自认知和身体障碍增长率的潜在压倒性挑战（Garcia等人，2022).通过医疗保险和医疗补助获得保险的老年人，被称为“双重杀手”，已成为试图控制州医疗补助支出增长的主要焦点，原因有几个。老年双重受益人占医疗补助接受者的14%，他们在医疗补助支出中所占的份额要高得多（32%）（Peña等人，2023年）。根据2020年人口普查数据，西班牙裔人口占美国总人口的18.9%;然而，西班牙裔老年人占美国双重资格个人的约22%，并且倾向于报告低收入和低储蓄（少数民族健康办公室，2023年; Peña等人，2023年）。超过40%的有双重资格的人报告说，他们至少有一项日常生活活动受到限制，
Numerous social and demographic forces, including high levels of marital disruption, older age at first birth, and lower total fertility have resulted in a decrease in average family size in the US over the twentieth century. Although Mexican Americans continue to have more children than non-Hispanics, they have experienced a decrease in average family size, which is likely to continue in the coming years (Angel & Angel, 2009). At the same time that families have become smaller, life spans have increased dramatically, especially among Mexican Americans, whose life expectancy at birth and older ages is longer than that of African Americans or European Americans (Arias and Xu, 2022). The result is an increasing old-age dependency ratio that presents potentially serious challenges to Mexican American families and to social policy at all levels of government (Angel et al., 2004). Longer lives are clearly desirable, especially if one experiences good health during the additional years (Angel et al., 2015). Unfortunately, previous research suggests that morbidity has not been significantly compressed and that a growing number of Mexican American communities, families, and systems of care will be confronted by a potentially overwhelming challenge from growing rates of cognitive and physical impairment (Garcia et al., 2022).Older individuals who receive insurance through both Medicare and Medicaid, known as “dual eligibles,” have become a major focus in attempts to control the growth in state Medicaid expenditures for several reasons. Older dual beneficiaries, who represent 14% of Medicaid recipients, consume a much higher share of Medicaid spending (32%)(Peña et al., 2023). According to 2020 Census data, the Hispanic population represents 18.9% of the total US population; however, Hispanic older adults represent about 22% of dual-eligible individuals in the US and tend to report low income and savings (Office of Minority Health, 2023; Peña et al., 2023). Over 40% of those who are dual eligible report having a limitation in at least one activity of daily living,