Comparative Study of Health Transitions in Later Life

描述(由申请人提供)：本方案是两个平行方案之一 来自不同机构的意见书构成了一个单一的项目。这个 主要调查人员：人口委员会的Zachary Zimmer和Mary Beth 奥斯特达尔，密歇根大学。该项目的总体目标是 描述和分析健康过渡和医疗保健利用模式 人口迅速老龄化的四个亚洲国家和社会经济 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)的老年人口， 菲律宾(1996、2000-2001)和新加坡(1995、1999)。亚洲小组 调查是第一个具有全国代表性的纵向数据 适用于这些国家/地区的老年人口，跨越了一个连续体 对社会经济发展的影响。比较法允许估计 对护理和支持的潜在需求在国家之间是如何变化的(即， 健康结果的流行率和过渡期)以及这些联系的普遍性 在社会经济地位、社会支持和健康之间 在西方许多发达国家都能观察到。该项目有三个具体的 目标：(1)估计健康结果的人口流行水平 (功能受限、慢性病和自评健康状况)， 检查国家内流行率水平的最新趋势，确定 个人水平的健康状况转换率和估计的活跃寿命 预期；(2)调查社会经济地位和家庭的影响 人群健康状况变迁的网络特征与社会支持 老年人；和(3)评估机会和需求作为决定因素的作用 检查个人和社区资源的卫生保健利用情况 特点。将采用各种分析技术，具体取决于 因变量的形式和特定分析的目标。 Logistic回归模型将用于健康患病率的分析 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医疗保健的分析 利用率。多项Logit模型将用于健康分析 过渡期；有效预期寿命将使用多态寿命进行检验 不同人口亚组的表格和结构方程模型将 用来检验社会经济地位和健康状况的交叉滞后效应。

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.