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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和相关痴呆症患者的影响

基本信息

批准号：
9982156
负责人：
Norma B Coe
金额：
$ 62.49万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-30 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9982156
关键词：
Address Advocate Age Alzheimer&apos s disease related dementia American Area Assisted Living Facilities Budgets Care given by nurses Caregivers Caring Clinical Communities Cost of Illness Country Data Data Set Databases Dedications Direct Costs Disease Economics Effectiveness Elderly Emergency department visit Emotional Evaluation Experimental Designs Facilities and Administrative Costs Family Financial Hardship Formal caregiver Friends Goals Government Financing Health Health Resources Health and Retirement Study Healthcare Home Nursing Care Home environment Hospitalization Independent Living Individual Industry Intuition Long-Term Care Longevity Measures Medicaid Medicare Medicare/Medicaid Mental Health Methods Nature Nursing Homes Outcome Patient Self-Report Patients Persons Play Policies Population Prevalence Privatization Psyche structure Research Residential Treatment Resources Retirement Role Sampling Science Severity of illness Source Techniques Training Work aged care costs care outcomes care providers care recipients cost disability experience functional disability health care availability health care service utilization informal care informal caregiver informal support instrument memory care patient oriented person centered physical conditioning psychologic social trend

项目摘要

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.

非正式护理对阿尔茨海默病及相关痴呆患者的影响