Age Difference of Spouses and Long-Term Care

配偶年龄差异与长期护理

• 批准号: 6400830
• 负责人: DARIUS N. LAKDAWALLA
• 金额: $ 8.65万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-15 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6400830
• 关键词: age difference; behavioral /social science research tag; caregivers; clinical research; epidemiology; extended care; family structure /dynamics; health care service utilization; health services research tag; human data; human old age (65+); marriage /marital status; nursing homes; person with disability; spouses; statistics /biometry; widowhood

National expenditures on long-term care currently total $100 billion annually in the US. The magnitude of these expenditures makes it imperative for us to understand past and future trends in long-term care demand. The aim of the proposed research is to examine how the declining age gap between spouses will affect future trends in the demand for long-term care. It has been well-established that the presence or absence of a healthy spouse is a major determinant of nursing home entrance: a disabled person married to a healthy spouse is about half as likely to enter a nursing home as a disabled person without a healthy spouse. In turn, the availability of healthy spouses may have been substantially affected by the shrinking age gap between spouses over the twentieth century. A woman born 1900 on average ended up with a husband who was 4.2 years older than she. The same woman born in 1950, however, would have ended up with a husband just 2.5 years older. We propose to show that this decline has two effects: (1) All elderly couples will tend to stay married longer, because they are more closely matched in age. (2) Today's elderly women will tend to have younger, healthier husbands, but today's elderly men will tend to have older wives. The first effect will reduce nursing home demand, while the second has an ambiguous effect. We propose to quantify both effects and estimate their overall effect on nursing home demand. First, we will use life table data from the Social Security Administration to compute the effect of the changing age gap on the prevalence of marriage among the elderly. Next, we propose to use data from the AHEAD study to estimate the probability of nursing home entrance by disability, marital status, and the age of a married person's spouse. As part of this analysis, we will use Census data to impute data on the ages of deceased spouses absent from the AHEAD. This analysis quantifies the effect of the changing age gap on the probability of nursing home entrance for married people. Using our estimates of the changing probability of being married, and the changing probability of nursing home entrance for married people, we then compute the total effect of the changing age gap on overall nursing home demand.

目前，美国每年用于长期护理的国家支出总额为1000亿美元。这些支出的规模使得我们必须了解长期护理需求的过去和未来趋势。拟议研究的目的是研究配偶之间年龄差距的缩小将如何影响长期护理需求的未来趋势。健康配偶的存在与否是进入养老院的一个主要决定因素，这一点已经得到公认：与健康配偶结婚的残疾人进入养老院的可能性大约是没有健康配偶的残疾人的一半。反过来，在世纪，配偶之间的年龄差距不断缩小，这可能对健康配偶的可获得性产生了重大影响。平均而言，1900年出生的女性最终的丈夫比她大4.2岁。然而，同样是1950年出生的女人，最终的丈夫只比她大2.5岁。我们建议表明，这种下降有两个影响：（1）所有老年夫妇都倾向于维持更长的婚姻，因为他们在年龄上更接近。(2)今天的老年妇女往往有更年轻、更健康的丈夫，但今天的老年男子往往有更年长的妻子。第一个影响将减少养老院的需求，而第二个影响是模糊的。我们建议量化这两种影响，并估计其对养老院需求的整体影响。首先，我们将使用社会保障局的生命表数据来计算年龄差距变化对老年人结婚率的影响。接下来，我们建议使用AHEAD研究的数据来估计残疾，婚姻状况和已婚人士配偶的年龄的养老院入口的概率。作为分析的一部分，我们将使用人口普查数据来估算不在AHEAD中的已故配偶的年龄数据。这一分析量化了年龄差距的变化对已婚人士进入养老院的可能性的影响。使用我们的估计结婚的变化概率，和养老院入口的已婚人士的变化概率，然后我们计算总的影响，不断变化的年龄差距对整体养老院的需求。