FINANCIAL BURDEN OF HEALTH CARE COSTS FOR THE ELDERLY

老年人医疗保健费用的经济负担

• 批准号: 2656408
• 负责人: Stephen Crystal
• 金额: $ 7.85万
• 依托单位: RUTGERS, THE STATE UNIV OF N.J.
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-09-30 至 1998-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2656408
• 关键词: Alzheimer's disease; Medicare /Medicaid; behavioral /social science research tag; clinical research; education; functional ability; gender difference; health care cost /financing; health care policy; health economics; health insurance; health services research tag; home health care; human data; human old age (65+); human population study; income; managed care; mental disorders; racial /ethnic difference; socioeconomics; statistics /biometry

Despite Medicare, out-of-pocket health care costs are substantial among the elderly population. However, the distribution of these costs is quite skewed. For many elders, their impact is modest, while for a subgroup they are sufficiently large in proportion to income to constitute a significant financial burden. It is important that the size and characteristics of this latter group be understood, so that health policies can be shaped so as to protect the vulnerable while containing overall costs, yet surprisingly little current information is available on this important question. The proposed study aims to address this gap using newly-available data, in a quick- turnaround project which is expected to bring timely new information to policy debates about financing health care for older people and the impact of alternative proposals to increase the extent to which they share in the costs of their health care. Using the first three waves of the Medicare Current Beneficiary Survey Cost and Use files, for the years 1992-1994, measures of financially burdensome health care costs among the elderly living in the community will be constructed by relating the level of out-of-pocket costs to current income. Utilizing the longitudinal design of the data, the project will distinguish elderly individuals with persistently high out-of-pocket costs relative to income from the elderly who experience financially burdensome costs only intermittently or not at all. The role of key demographic, socioeconomic, and health variables in the determination of financially burdensome costs will be explored, including race, gender, education, supplemental insurance benefits, managed care participation, functional impairment, self-rated health status, mental illness, Alzheimer's disease, the presence of other specific medical conditions, and use of home health care services. The multivariate analyses will incorporate statistical techniques which recognize that managed care participation and supplemental insurance coverage are choice variables which may reflect unobservable individual characteristics that affect the probability of financially burdensome costs. Finally, the project will assess changes over the 1992-94 period in the incidence of financially burdensome cost, and explore the role of managed care growth and other policy developments in these trends.

尽管有医疗保险，但自付费用的医疗费用仍然很高 在老年人口中。 然而，这些的分布 成本是相当倾斜的。 对于许多长辈来说，他们的影响微乎其微， 而对于一个子群来说，它们的比例足够大 收入构成重大的经济负担。 这很重要 了解后一群体的规模和特征，因此 可以制定卫生政策以保护弱势群体 虽然包含总体成本，但目前的成本却令人惊讶地少 关于这个重要问题的信息是可用的。 拟议的 研究旨在利用新获得的数据快速解决这一差距 周转项目有望带来及时的新信息 关于为老年人和老年人提供医疗保健融资的政策辩论 替代提案的影响，以提高其影响程度 分担他们的医疗保健费用。 使用前三波 医疗保险当前受益人调查成本和使用文件，用于 1992-1994年，经济负担沉重的保健措施 居住在社区的老年人的成本将被建立 将自付费用水平与当前收入联系起来。 利用数据的纵向设计，该项目将 区分自付费用持续较高的老年人 与经济困难的老年人的收入相关的成本 繁重的成本只是间歇性地或根本不存在。 钥匙的作用 人口、社会经济和健康变量 将探讨确定经济负担重的费用， 包括种族、性别、教育程度、补充保险福利、 管理式护理参与、功能障碍、自评健康 状况、精神疾病、阿尔茨海默病、其他疾病的存在 特定的医疗状况以及家庭医疗保健服务的使用。 多变量分析将结合统计技术 认识到管理式医疗参与和补充保险 覆盖率是可能反映不可观察的选择变量 影响财务概率的个人特征 繁重的费用。 最后，该项目将评估 1992-94 年期间经济负担沉重的费用发生率，以及 探索管理式医疗增长和其他政策的作用 这些趋势的发展。