Effects of EITC on Formal Long-Term Care for Older Adults with and without AD/ADRD
EITC 对患有和不患有 AD/ADRD 的老年人正规长期护理的影响
基本信息
- 批准号:10573493
- 负责人:
- 金额:$ 18.42万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-01-01 至 2024-12-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAffectAgeAlzheimer&aposs DiseaseAlzheimer&aposs disease related dementiaCaregiversCaringChronic DiseaseComplementCost AnalysisCosts and BenefitsDataData SetDiagnosisDimensionsEducational StatusElderlyEthnic OriginEventExpenditureFamilyFamily SizesFormal caregiverFriendsGenderGoalsHealthHealth Care CostsHealth PersonnelHealth and Retirement StudyHealthcare SystemsHomeIncomeIncome TaxIndividualInstitutionKnowledgeLeadLifeLife ExpectancyLiteratureLong-Term CareLow Income PopulationLow incomeMarital StatusMarketingMental HealthMethodsNational Institute on AgingOutcomePatientsPersonal SatisfactionPersonsPoliciesPolicy MakerPopulationPositioning AttributePovertyPreventionProviderQuasi-experimentRaceResearchStressTaxesTestingTimeUnited States National Institutes of HealthWagesWorkagedcare giving burdencare providerscare recipientscopingcost effectivedesignexperiencehealth dataimprovedinformal careinnovationinsightinterestphysical conditioningpolicy implicationpopulation surveypressureprograms
项目摘要
Abstract. Over 70 percent of older adults aged 65 or older require assistance from caregivers with basic
functions at some point in their lifetime, and more than six million older adults in the US have Alzheimer’s disease
and Alzheimer’s disease-related dementias (AD/ADRD) and require more extensive assistance than their
counterparts without AD/ADRD. About one-third of older adults who require assistance receive help from formal
providers at home or an institution. These formal long-term care (LTC) providers have low and stagnant wages
with few benefits, which have resulted in a severe shortage of and a high turnover rate for formal care providers.
The situation is particularly dire for low-income formal caregivers. The Earned Income Tax Credit (EITC) is a tax
credit for low- and moderate-income working families and is one of the largest and most effective anti-poverty
programs in the US. The EITC could impact care for older adults because it encourages work, supplements
incomes, and improves physical and mental health and overall wellbeing for persons with low incomes. However,
despite a vast literature on the EITC, little is known about its effects on formal care for older adults. We propose
to fill this knowledge gap by leveraging a large number of plausibly exogeneous policy changes in the EITC at
the federal and state levels in the past two decades and using difference-in-differences and event-study
approaches and large, nationally representative data sets (Health and Retirement Study and Current Population
Survey) to examine the effects of the EITC on formal care provision and utilization along several important
dimensions including the care recipients’ AD/ADRD status. Specifically, we will pursue the following aims: Aim
#1: We will test how the EITC has changed the supply of formal LTC for those most likely to be affected by the
EITC—low-income individuals aged 18-64—using the Current Population Survey. Aim #2: We will test how the
EITC has changed older adults’ utilization of and out-of-pocket expenditures on formal LTC, including home and
institutional care, using the public and restricted data from the Health and Retirement Study (HRS). Aim #3
(exploratory): Depending on the findings from the first two aims, we will examine whether estimated changes in
formal LTC lead to changes in the intensity and type of informal care utilized by older adults using the HRS data,
given that formal and informal LTC could be substitutes or complements for older adults. This study directly
addresses the goal of the National Institute on Aging to “Find significantly improved and cost-effective ways to
reduce caregiver, family, and patient stress and improve older adults’ ability to cope with chronic disease”.
Findings from this study will have significant policy implications, as the size and the life expectancy of the older
adult population, especially the population with AD/ADRD, and the costs of health care continue to rise, putting
unprecedented pressure on the health care system. We will also provide valuable information to policymakers
interested in designing effective population-level policies to support health care workers, especially the most
vulnerable low-income health care workers.
1
抽象。超过70%的65岁或65岁以上的老年人需要照顾者的帮助,
在美国,有超过600万的老年人患有阿尔茨海默病,
和阿尔茨海默病相关痴呆症(AD/ADRD),需要比他们更广泛的援助。
没有AD/ADRD的同行。大约三分之一需要帮助的老年人得到正规机构的帮助。
提供者在家里或机构。这些正规的长期护理(LTC)提供者的工资很低,而且停滞不前
福利很少,导致正规护理提供者严重短缺和更替率高。
对于低收入的正规照料者来说,情况尤其严峻。所得税抵免(EITC)是一种税收。
信贷低收入和中等收入的工薪家庭,是最大和最有效的反贫困之一
在美国的节目。EITC可能会影响老年人的护理,因为它鼓励工作,补充
提高收入,改善低收入者的身心健康和总体福祉。但是,在这方面,
尽管有大量关于EITC的文献,但很少有人知道它对老年人正规护理的影响。我们提出
通过利用EITC中大量看似外生的政策变化来填补这一知识空白,
在过去的二十年里,联邦和州一级的差异,并使用差异中的差异和事件研究
方法和大型的,全国代表性的数据集(健康和退休研究和当前人口
调查),以审查的影响,EITC对正规保健的提供和利用沿着几个重要的
包括护理接受者的AD/ADRD状态。具体而言,我们将努力实现以下目标:
#1:我们将测试EITC如何改变那些最有可能受到影响的正式LTC的供应。
EITC-18-64岁的低收入个人-使用当前人口调查。目标#2:我们将测试
EITC改变了老年人对正式LTC的使用和自付支出,包括家庭和
机构护理,使用健康和退休研究(HRS)的公共和限制数据。目标3
(探索性):根据前两个目标的结果,我们将研究
使用HRS数据,正式LTC导致老年人使用的非正式护理的强度和类型发生变化,
考虑到正式和非正式的LTC可以作为老年人的替代或补充。这项研究直接
解决了国家老龄化研究所的目标,“找到显着改善和成本效益的方法,
减少照顾者、家庭和病人的压力,提高老年人科普慢性病的能力。
这项研究的结果将具有重大的政策意义,因为老年人的规模和预期寿命
成年人口,特别是AD/ADRD人口,以及医疗保健费用继续上升,
医疗保健系统面临前所未有的压力。我们还将为决策者提供有价值的信息
有兴趣设计有效的人口水平的政策,以支持卫生保健工作者,特别是最
弱势的低收入医护人员。
1
项目成果
期刊论文数量(0)
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{{ truncateString('Yang Wang', 18)}}的其他基金
Federal Minimum Wage Expansion and Home Care Utilization and Costs for Older Adults
联邦最低工资扩展以及老年人的家庭护理利用和费用
- 批准号:
10573547 - 财政年份:2023
- 资助金额:
$ 18.42万 - 项目类别:
Neurovascular Uncoupling and Cognitive Impairments of Long COVID in Aging
衰老过程中长新冠病毒的神经血管解偶联和认知障碍
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10537136 - 财政年份:2022
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The Effects of the Affordable Care Act Medicaid Expansion on Informal Care
《平价医疗法案》医疗补助扩展对非正式医疗的影响
- 批准号:
10351420 - 财政年份:2022
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Neurovascular Uncoupling and Cognitive Impairments of Long COVID in Aging
衰老过程中长新冠病毒的神经血管解偶联和认知障碍
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