EFFECT OF FORMAL HOME CARE SERVICES ON CAREGIVER BURDEN

正规家庭护理服务对护理人员负担的影响

• 批准号: 6200305
• 负责人: ANDREA L WEINER
• 金额: $ 3.21万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-06-15 至 2001-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6200305
• 关键词: Medicare /Medicaid; caregivers; clinical research; family structure /dynamics; frail elderly; health care service evaluation; health services research tag; home health care; human subject; low socioeconomic status; population survey

This proposal will provide a better understanding of the dynamics of family caregiving to low income and frail elderly individuals living in the community, as well as to test the ability of a program enrolling Medicare- and Medicaid-eligible individuals to support the role of informal care. The proposed research will accomplish these objectives within the context of the Minnesota Senior Health Options (MSHO) program, a Medicare- and Medicaid-capitated, integrated health care program for seniors who are "dually-eligible" (i.e. eligible for Medicare based on their age and eligible for Medicaid based on their socioeconomic status). This study uses data from a survey of home and community based MSHO enrollees and two sets of matched controls not enrolled in MSHO to examine the following specific objectives: 1. To test whether coverage of dual eligible individuals through the MSHO program reduces family caregiver burden, in comparison to those not enrolled in MS HO. 2. To determine if family caregiver burden decreases with increased amount and frequency of home care services, including home health care services, and whether increased skill level of the formal home care provider will result in lower levels of caregiver burden. 3. To determine whether formal care use decreases family caregiver burden for patients in the MSHO and non-MS HO groups, and whether the impact of MSHO on family caregiver burden is a function of formal care use. To address these research aims, the Principal Investigator will use a social support conceptual framework to examine how community and home care services moderate the effect of stressors such as care recipient impairment on caregiver burden. Ordinary least squares regression and structural equation modeling will be used to carry out the analyses.

这项提案将更好地了解为居住在社区的低收入和虚弱老年人提供家庭护理的动态，并测试一项计划的能力，该计划招募符合联邦医疗保险和医疗补助资格的个人支持非正式护理的作用。拟议的研究将在明尼苏达州老年健康选择(MSHO)计划的背景下实现这些目标，MSHO计划是一个由联邦医疗保险和医疗补助出资的综合医疗保健计划，面向“双重资格”的老年人(即根据他们的年龄有资格享受联邦医疗保险，根据他们的社会经济地位有资格获得医疗补助)。这项研究利用对家庭和社区MSHO参与者的调查数据和两组没有参加MSHO的匹配对照来检查以下具体目标：1.测试通过MSHO计划覆盖双重合格个人是否与那些没有参加MSHO的人相比减少了家庭照顾者的负担。2.确定家庭照顾者负担是否随着家庭护理服务(包括家庭保健服务)数量和频率的增加而减少，以及正规家庭护理提供者技能水平的提高是否会导致照顾者负担水平降低。3.确定MSHO组和非MSHO组患者的正式护理使用是否减轻了家庭照顾者的负担，以及MSHO对家庭照顾者负担的影响是否与正式护理使用有关。为了达到这些研究目标，首席调查员将使用社会支持概念框架来研究社区和家居护理服务如何缓解压力因素(如护理接受者受损)对照顾者负担的影响。采用普通最小二乘回归和结构方程模型进行分析。