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 劳动力市场状况和为老年人提供的长期护理的质量 美国人口迅速老龄化，阿尔茨海默病和相关痴呆症的发病率很高 （ADRD）预计将导致对长期护理（LTC）服务的需求大幅增加。 要充分满足这一需求并确保老年人能够有尊严地老年，就需要 庞大且高素质的 LTC 员工队伍。然而，低工资加上高要求的工作使人们很难 填补目前疗养院护理助理和家庭保健助理的职位。这引发了 人们对美国长期护理服务质量持续低下中劳动力所扮演的角色以及护理人员能力的担忧表示担忧。 目前的长期护理人员供应可以满足未来的需求。政策制定者有许多工具可以影响 长期护理人员的质量和数量，但缺乏关于具体影响的经验证据 这些政策杠杆取决于长期护理人员劳动力的规模和性质，或者取决于交付给长期护理人员的质量。 老年人。在长期（1999-2018）和富裕时期利用劳动力市场政策的广泛变化 来自 CMS 的结果数据，我们将解决有关政府政策如何实施的几个重要问题 可能会影响长期护理人员的劳动力和老年人的结果。该项目有四个具体目标。目标1、检查 州长期护理工人法规对长期护理质量的影响，研究了专门针对长期护理人员的政策 长期护理部门，包括疗养院和家庭助理的最低培训要求以及最低人员配备 对疗养院的要求。目标 2，评估政府劳动力市场政策如何影响 LTC 质量， 评估最低工资、所得税抵免和儿童保育税收抵免，三项联邦和州税收抵免 已被证明对整个劳动力市场有重大影响的政策。目标 3，检查 移民政策对 LTC 质量的影响，首先记录移民流动对规模的影响 疗养院和人民之家的长期护理人员劳动力的比例，然后使用工具变量 研究移民工人数量变化如何影响患者质量结果的技术。目标4， 为了评估劳动力市场政策对 ADRD 护理的影响，重点关注患有 ADRD 的个人，该群体是 严重依赖长期护理 (LTC)，并且可能特别受到长期护理 (LTC) 劳动力变化的影响，因为他们 脆弱性和对专门护理的潜在需求。总而言之，这组分析将提供一种新颖的 通过这个镜头来观察推动长期护理数量和质量的政府劳动力市场政策。结果 可以为旨在促进充足的劳动力来满足国家需求的基于证据的政策制定提供信息 对长期护理服务的需求不断增加。