Labor Market Conditions and the Quality of Long-Term Care Provided to Older Adults

其他项目信息-项目概要/摘要 劳动力市场状况和为老年人提供的长期护理质量 美国人口的迅速老龄化，阿尔茨海默病和相关痴呆症的发病率很高 （ADRD），预计将导致对长期护理（LTC）服务的需求大幅增加。 要满足这一需求并确保老年人能够有尊严地过上晚年， 高素质的LTC员工队伍。然而，低工资，加上高要求的工作， 填补目前的职位，为护理助理在疗养院和家庭保健助理。这就提出 担心劳动力在美国长期培训质量持续低下中的作用，以及 以满足未来的需求。政策制定者有许多工具来影响 长期培训中心劳动力的质量和数量，但缺乏关于具体影响的经验证据 这些政策杠杆对LTC劳动力的规模和性质，或对LTC交付的质量， 老年人利用长期（1999-2018年）劳动力市场政策的广泛变化， 从CMS的结果数据，我们将解决几个重要的问题，政府政策如何 可能会影响LTC劳动力和老年人的结果。该项目有四个具体目标。目标1：检查 州LTC工人法规对LTC质量的影响，检查专门针对 长期培训部门，包括对疗养院和家庭助理的最低培训要求以及最低工作人员配备 对养老院的要求。目标2，评估政府劳动力市场政策如何影响LTC质量， 评估最低工资，所得税抵免，儿童保育税收抵免，三个联邦和州 已被证明对整个劳动力市场有重大影响的政策。目标3，检查 移民政策对LTC质量的影响，首先记录了移民流动对规模的影响 的LTC劳动力，无论是在养老院和人民的家园，然后使用工具变量 技术，以检查如何在移民工人的股票变化影响病人的质量结果。目标4， 评估劳动力市场政策对ADRD护理的影响，重点关注ADRD患者， 严重依赖LTC，并且可能特别受到LTC劳动力变化的影响， 脆弱性和对专门护理的潜在需求。综合起来，这组分析将提供一个新的 通过透镜来观察政府劳动力市场政策，这些政策推动了长期培训的数量和质量。结果 可以为循证决策提供信息，以促进充足的劳动力， 对LTC服务的需求不断增加。

OTHER PROJECT INFORMATION – Project Summary/Abstract Labor Market Conditions and the Quality of Long-Term Care Provided to Older Adults The rapid aging of the U.S. population, with high rates of Alzheimer's Disease and related dementias (ADRD),is expected to result in substantial increases in the demand for long term care (LTC) services. Adequately meeting this demand and ensuring that older adults are able to age with dignity will require both a large and high-quality LTC workforce. Yet low wages, combined with highly demanding work, make it difficult to fill current positions for nursing assistants at nursing homes and for home health care aides. This raises concerns about the role of the workforce in the persistently low quality of LTC in the U.S. and the ability of the current supply of LTC workers to meet future demand. Policy makers have a number of tools to influence the quality and quantity of the LTC workforce, but there is a lack of empirical evidence about the specific impacts these policy levers have on the size and nature of the LTC workforce, or on the quality of LTC delivered to older adults. Using extensive variation in labor market polices over a long time range (1999-2018) and rich outcomes data from the CMS, we will address several important questions about how government policies might impact the LTC workforce and elder outcomes. The project has four Specific Aims. Aim 1, to examine the impact of state LTC worker regulations on the quality of LTC, examines policies targeted specifically at the LTC sector, including minimum training requirements for nursing home and home aides and minimum staffing requirements for nursing homes. Aim 2, to assess how government labor market policy affects LTC quality, evaluates minimum wages, earned income tax credits, and child care tax credits, three federal and state policies that have been shown to have significant effects on the overall labor market. Aim 3, to examine the impact of immigration policy on LTC quality, first documents the impact that immigration flows have on the size of the LTC workforce, both in nursing homes and people's homes, and then uses instrumental variable techniques to examine how changes in the stock of immigrant workers impact patient quality outcomes. Aim 4, to assess impacts of labor market policy on ADRD care, focuses on individuals with ADRD a group that is heavily dependent on LTC and may be particularly affected by changes in the LTC workforce due to their vulnerability and potential need for specialized care. Taken together, this set of analyses will provide a novel lens through which to view government labor market policies that drive the quantity and quality of LTC. Results can inform evidence-based policy making designed to promote an adequate workforce to meet the country's increasing demand for LTC services.