Labor Market Conditions and the Quality of Long-Term Care Provided to Older Adults

劳动力市场状况和为老年人提供的长期护理的质量

• 批准号: 10097276
• 负责人: DAVID C GRABOWSKI
• 金额: $ 39.48万
• 依托单位: NATIONAL BUREAU OF ECONOMIC RESEARCH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-15 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10097276
• 关键词: Address; Affect; Age; Aging; Alzheimer' s disease related dementia; Caring; Child Care; Complex; Consensus; Country; Data; Data Set; Disabled Persons; Discipline of Nursing; Economics; Elderly; Ensure; Equilibrium; Federal Government; Future; Generations; Government; Growth; Health; Home; Home Care Services; Home Nursing Care; Immigrant; Immigration; Income Tax; Individual; Labor Forces; Licensing; Link; Literature; Long-Term Care; Medicaid; Medicare claim; Monitor; Nature; Nursing Homes; Outcome; Outcome Assessment; Parents; Pathway interactions; Patient Care; Patient-Focused Outcomes; Patients; Pattern; Police; Policies; Policy Maker; Policy Making; Population; Positioning Attribute; Price; Production; Quality of Care; Regulation; Research; Resources; Role; Services; Side; State Government; Taxes; Techniques; Time; Training; Variant; Visiting Nurse; Wages; Work; baby boomer; care costs; care systems; cost; dementia care; design; evidence base; federal policy; improved; instrument; lens; meetings; novel; patient home care; payment; tool

OTHER PROJECT INFORMATION – Project Summary/Abstract Labor Market Conditions and the Quality of Long-Term Care Provided to Older Adults The rapid aging of the U.S. population, with high rates of Alzheimer's Disease and related dementias (ADRD),is expected to result in substantial increases in the demand for long term care (LTC) services. Adequately meeting this demand and ensuring that older adults are able to age with dignity will require both a large and high-quality LTC workforce. Yet low wages, combined with highly demanding work, make it difficult to fill current positions for nursing assistants at nursing homes and for home health care aides. This raises concerns about the role of the workforce in the persistently low quality of LTC in the U.S. and the ability of the current supply of LTC workers to meet future demand. Policy makers have a number of tools to influence the quality and quantity of the LTC workforce, but there is a lack of empirical evidence about the specific impacts these policy levers have on the size and nature of the LTC workforce, or on the quality of LTC delivered to older adults. Using extensive variation in labor market polices over a long time range (1999-2018) and rich outcomes data from the CMS, we will address several important questions about how government policies might impact the LTC workforce and elder outcomes. The project has four Specific Aims. Aim 1, to examine the impact of state LTC worker regulations on the quality of LTC, examines policies targeted specifically at the LTC sector, including minimum training requirements for nursing home and home aides and minimum staffing requirements for nursing homes. Aim 2, to assess how government labor market policy affects LTC quality, evaluates minimum wages, earned income tax credits, and child care tax credits, three federal and state policies that have been shown to have significant effects on the overall labor market. Aim 3, to examine the impact of immigration policy on LTC quality, first documents the impact that immigration flows have on the size of the LTC workforce, both in nursing homes and people's homes, and then uses instrumental variable techniques to examine how changes in the stock of immigrant workers impact patient quality outcomes. Aim 4, to assess impacts of labor market policy on ADRD care, focuses on individuals with ADRD a group that is heavily dependent on LTC and may be particularly affected by changes in the LTC workforce due to their vulnerability and potential need for specialized care. Taken together, this set of analyses will provide a novel lens through which to view government labor market policies that drive the quantity and quality of LTC. Results can inform evidence-based policy making designed to promote an adequate workforce to meet the country's increasing demand for LTC services.

其他项目信息 - 项目摘要/摘要 劳动力市场状况以及为老年人提供的长期护理质量 美国人口的迅速衰老，阿尔茨海默氏病和相关痴呆症的率很高 （ADRD）预计将导致长期护理（LTC）服务的需求大幅增加。 充分满足这一需求，并确保老年人能够以尊严的衰老将需要 大而高质量的LTC劳动力。然而，低工资，加上高要求的工作，使得很难 填补护士助理和家庭保健助手的当前职位。这加剧了 对劳动力在LTC持续低质量中的作用的担忧以及美国的能力 LTC工人当前的供应以满足未来需求。政策制定者有多种影响 LTC劳动力的质量和数量，但缺乏有关具体影响的经验证据 这些政策杠杆具有LTC劳动力的规模和性质，或交付给LTC的质量 老年人。在长期（1999-2018）和RICH上使用劳动力市场政策的广泛差异 来自CMS的结果数据，我们将解决有关政府政策如何的几个重要问题 可能会影响LTC劳动力和老年人的成果。该项目具有四个具体目标。目标1，检查 国家LTC工人法规对LTC质量的影响，审查了针对针对的政策 LTC领域，包括护士家庭和家庭助手的最低培训要求以及最低人员配备 护士房屋的要求。目的2，评估政府劳动市场政策如何影响LTC质量， 评估最低工资，赚取的所得税信用和托儿税抵免，三个联邦和州 已证明对整个劳动力市场产生重大影响的政策。目标3，检查 移民政策对LTC质量的影响，首先记录了移民流对大小的影响 LTC劳动力的护士和人们的家中，然后使用工具变量 研究移民工人库存的变化如何影响患者质量结果。目标4， 为了评估劳动力市场政策对ADRD护理的影响，专注于ADRD的个人 严重依赖LTC，可能会特别受LTC劳动力变化的影响 脆弱性和潜在的专业护理需求。综上所述，这组分析将提供新颖 查看推动LTC数量和质量的政府劳动力市场政策的视角。结果 可以为旨在促进足够的劳动力来满足该国的基于证据的政策制定 对LTC服务的需求增加。