Comparative Study of Health Transitions in Later Life

描述（由申请人提供）：本提案是两个平行提案之一 来自不同机构的意见书构成一个单一的项目。的 主要研究者是：Zachary Zimmer，人口理事会和玛丽贝丝 密歇根大学的Ofstedal。该项目的总体目标是 描述和分析健康过渡和卫生保健利用模式， 四个亚洲国家正在经历人口迅速老龄化和社会经济 变化这项研究涉及对最近的小组调查的比较分析， 台湾（1989-1999）、印度尼西亚（1993、1997、1998）、 菲律宾（1996年，2000-2001年）和新加坡（1995年，1999年）。亚洲小组 调查代表了第一个具有全国代表性的纵向数据， 这些国家的老年人口情况， 社会经济发展。比较方法允许估计 各国对护理和支持的潜在需求如何变化（即， 流行率和健康结果的转变）以及这些联系的可推广性 社会经济地位，社会支持和健康之间的关系， 在西方许多发达国家都能看到。该项目有三个具体 目的：（1）估计健康结果的人口流行水平 （功能受限、慢性病和自我评估的健康状况）， 审查各国流行率的近期趋势，确定 健康状况的个人水平转变率和估计的活跃寿命 期望;（2）调查社会经济地位和家庭的影响 网络特征和社会支持对健康状况转变的影响 （3）评估获得和需要作为老年人的决定因素的作用， 通过检查个人水平和社区资源卫生保健利用 特色将采用各种分析技术，这取决于 因变量的形式和特定分析的目标。 将使用逻辑回归模型分析健康流行率 结果和患病率水平的变化，以及逻辑和 线性回归技术将用于分析卫生保健 利用率将使用多项logit模型分析健康状况 过渡;积极的预期寿命将使用多态寿命进行检查 不同人口亚组的表，结构方程模型将 用于测试社会经济地位和健康的交叉滞后效应。

DESCRIPTION (provided by applicant): This proposal is one of two parallel submissions from separate institutions constituting a single project. The Principal Investigators are: Zachary Zimmer, Population Council, and Mary Beth Ofstedal, University of Michigan. The overall goal of the project is to describe and analyze health transitions and health care utilization patterns in four Asian countries undergoing rapid population aging and social and economic change. The study involves comparative analyses of recent panel surveys of older populations in Taiwan (1989-1999), Indonesia (1993, 1997, 1998), the Philippines (1996, 2000-2001), and Singapore (1995, 1999). The Asian panel surveys represent the first nationally-representative, longitudinal data available on the older population for these countries, which span a continuum of socioeconomic development. The comparative approach allows for estimates of how the potential demand for care and support varies between countries (i.e., prevalence and transitions in health outcomes) and how generalizable the links are between socioeconomic status, social support and health that have been observed in many developed nations in the West. The project has three specific aims: (1) to estimate population prevalence levels of health outcomes (functional limitation, chronic conditions, and self-assessed health status), examine recent trends in prevalence levels within countries, determine individual-level transition rates in health status, and estimate active life expectancy; (2) to investigate the effects of socioeconomic status and family network characteristics and social support on health status transitions among older adults; and (3) to assess the roles of access and need as determinants of health care utilization by examining individual-level and community resource characteristics. A variety of analytic techniques will be employed depending on the form of the dependent variable and the goal of the particular analysis. Logistic regression models will be utilized in analyses of prevalence of health outcomes and changes in prevalence levels, and a combination of logistic and linear regression techniques will be used in analyses of health care utilization. Multinomial logit models will be used for analyses of health transitions; active life expectancy will be examined using multistate life tables for different population subgroups, and structural equation models will be used to test for cross-lagged effects of socioeconomic status and health.