Effects of Informal Care for persons with Alzheimer's Disease and related dementias

非正式护理对阿尔茨海默病及相关痴呆患者的影响 目前关于如何最好地满足日益增长的以患者为中心的高质量长期护理的需求的辩论 在尽可能限制最少的情况下，对ADRD患者的定期护理几乎完全集中在直接 以及每种护理的间接费用。一个关键的缺失部分是对这些好处的比较。在接收的同时 非正式护理看起来似乎很有吸引力，但令人惊讶的是，我们目前对其影响知之甚少 根据接受护理的个人的结果进行选择。 我们的研究将是第一个衡量非正式和正式长期接收的因果影响的研究 主要使用健康和退休研究，为护理接受者提供关键和多方面的结果护理， 这是一组具有全国代表性的50岁美国人的数据。我们的分析将包括所有收到 长期护理，以及ADRD患者的亚样本，因为非正式护理费用占 约占疾病总成本的一半。我们的健康结果包括一套丰富的自我报告的身体状况， 精神、情绪和社会健康措施，以及自我报告和行政保健利用 措施。为了估计正式护理和非正式护理的因果影响，我们使用了工具变量 在过去的几年中，已成功用于预测非正式护理接受的技术和工具 使用相同的数据集工作。此外，我们提出了新的和有希望的工具，包括供应 市场上有正规的护理服务。最后，我们的研究是第一次对所有形式的 正规护理，包括过多的私人付费住宿护理选择。为了做到这一点，这项研究将 区域卫生资源文件(AHRF)和NIC-MAP数据库，业界首屈一指的数据集，涉及 长期护理市场。 使用这种方法，我们的研究提出了以下具体目标：描述 全面扩大公共和私人资助的正规护理在当地市场的供应情况 以及它与非正式护理的相关性，并量化以下因素引起的护理接受者结果的差异 接受非正式护理与正式护理相比。这一建议将告知政策权衡，即支持非正式 护理提供者和扩大公共资助的正规护理选择。

Effects of Informal Care for persons with Alzheimer's Disease and Related Dementias The current debate about how best to meet the growing demand for patient-centered, high-quality long- term care for persons with ADRD in the least restrictive setting possible has centered almost solely on the direct and indirect costs of each type of care. A crucial missing piece is a comparison of the benefits. While receiving informal care may seem intuitively appealing, we currently know surprisingly little about the implications of this choice for outcomes of the individuals receiving the care. Our study would be the first to measure the causal impact of receiving informal versus formal long-term care on key and multi-faceted outcomes for the care recipient, primarily using the Health and Retirement Study, a nationally-representative dataset of Americans age 50+. Our analysis would include all individuals receiving long-term care, as well as a sub-sample of individuals living with ADRD, since informal care costs account for approximately half the total costs of the disease. Our health outcomes include a rich set of self-reported physical, mental, emotional, and social health measures, as well as self-reported and administrative health care utilization measures. In order to estimate the causal impact of formal and informal care, we employ instrumental variable techniques and a set of instruments that have been successfully used to predict informal care receipt in previous work using the same dataset. In addition, we propose new and promising instruments, including the supply of formal care available in the market. Finally, our study is the first to take a comprehensive look at all forms of formal care, including the plethora of private-pay residential care options. To do so, this research brings together the Area Health Resource Files (AHRF) and the NIC-MAP database, the industry's premiere dataset concerning the long-term care market. Using this approach, our study proposes to address the following specific aims: to describe comprehensively an expanded profile of the supply of publicly and privately financed formal care in local markets and its correlation with informal care, and to quantify the difference in care recipient outcomes caused by receiving informal versus formal care. This proposal will inform the policy tradeoffs between supporting informal care providers and expanding publicly financed formal care options.