Estimating the Demand for Medicaid Financial Long-Term Care for the Elderly

描述（由申请人提供）：本次申请K01奖是为了促进Arpita Chattopadhyay博士过渡到老年流行病学和长期护理领域的独立研究者，重点是医疗补助政策。她的长期目标是建立一个跨学科项目，将老龄化和残疾的生物医学研究与经济学和社会学的行为研究联系起来，重点研究老年人长期护理的利用和融资。培养目标是：(1)掌握老龄化和长期护理政策的社会学和经济学方面的实质性知识；(2)掌握发展残疾随机模型的新技能；(3)制定一个框架，用于评估残疾、长期护理使用和融资的决定因素。指导小组包括经验丰富的卫生服务研究员安德鲁·宾德曼（Andrew Bindman）博士；Drs。长期护理问题专家罗伯特·纽卡姆和夏琳·哈灵顿；Peter Bacchetti博士，慢性病建模随机过程专家；以及专门研究老龄化人口统计学的罗纳尔·李博士

DESCRIPTION (provided by applicant): This application for a K01 award is to facilitate Dr. Arpita Chattopadhyay's transition to an independent investigator in the field of epidemiology of aging and long-term care with a focus on Medicaid policy. Her long-term goal is to develop an interdisciplinary program linking biomedical research on aging and disability with behavioral research in economics and sociology that focuses on utilization and financing of long-term care among the elderly. The training goals are (1) to acquire substantive knowledge in sociology and economics of aging and long-term care policies; (2) to acquire new skills in developing stochastic models of disability; and (3) to develop a frame work for estimating the determinants of disability, long-term care use, and financing. The mentoring team includes Dr. Andrew Bindman, an experienced health services researcher; Drs. Robert Newcomer and Charlene Harrington, experts in long-term care issues; Dr. Peter Bacchetti, expert in stochastic processes in chronic disease modeling; and Dr. Ronal Lee, who specializes in the demography of aging The impact of changing racial and ethnic composition on the demand for long-term care and utilization of Medicaid for financing long-term care has not been studied. This research will overcome this shortcoming by incorporating race and ethnicity into projection models for long-term care demand and Medicaid use among the elderly. The research will address two of the priority areas at the NIA, namely aging and health /healthcare disparities and efficiency of the health system. Drawing upon data from sample surveys and administrative sources on service use, this research proposes four specific aims that correspond to four structural determinants of future long-term care use and financing. Aim 1 will determine racial and ethnic differences in age-specific prevalence of disability. Aim 2 will determine racial and ethnic differences in age specific use of long-term care for a given level of disability. Aim 3 will determine the racial and ethnic differences in use of Medicaid among the disabled elderly. Aims 1-3 will then be combined and used to obtain stochastic projection of elderly Medicaid beneficiaries in long-term care (Aim 4). A detailed microsimulation model incorporating behavioral and structural determinants of using Medicaid financed longterm care will be proposed for an R01 project at the end of the K01.