Advancing Long -Term Care Research by Linking HRS and LTC Focus

描述（由申请人提供）：美国NIA资助的长期护理计划项目拨款（PPG） [p -1- ag - 27296]在布朗大学老年学和卫生保健研究中心进行，旨在研究国家政策和市场力量如何影响美国养老院护理的可用性和质量。除了正在进行的4个项目外，PPG的一个目标是将美国长期护理（LTC）系统结构的数据以公共使用的形式提供给潜在的研究人员。布朗大学的研究人员汇编了2000年至2010年期间养老院居民的健康和功能状况、护理机构的特点、州长期护理报销政策以及养老院所在市场的特点的详细数据。这些数据目前可以在项目网站http://ltcfocus.org/上获得，可以交互式地使用，整个数据库可以在供应商、县或州的汇总级别上下载，允许研究人员解决他们自己的问题。该网站已被访问近2万次，数据被近1000人下载，因此他们可以探索与长期护理市场供应方面相关的研究问题。尽管迄今为止它们在理解提供者行为和记录美国养老院的时间和地理差异方面很有用，但可以解决与个人层面数据相关的全新一类问题。由于健康与退休研究（HRS）是对老年人口进行的规模最大、持续时间最长的全国性调查，因此，我们将这些数据与HRS联系起来，显然是我们努力的延伸。将居民信息（即邮政编码、县或州代码）或提供者识别号码联系起来，就有可能估计市场和提供者特征（如质量、再住院、服务组合等）对个人长期护理服务使用选择的影响。同样，县级数据（如该县养老院的床位数量）和州一级政策数据（如医疗补助支付率）也可用。事实上，县和州一级的数据可以与人力资源调查数据一起使用，而不管这些数据是否也与提供者文件相关联，因为它们提供的背景信息可能会影响老年人的选择和老年人所经历的结果。这个数据归档提案的总体目标是将LTCFocus转换为可链接到HRS限制数据文件的现成模块。该项目的具体目标是：1)更新、清理和转换2000年至2010年供应商、县和州一级的LTCFocus数据为可下载的文件，可以与HRS数据链接；2)编制符合HRS文件标准的用户手册；3)通过分析与LTCFocus数据相关的HRS限制文件来测试最终产品，修改并将最终产品交付给HRS。

DESCRIPTION (provided by applicant): The Shaping Long-Term Care in America NIA funded program project grant (PPG) [P0-1-AG- 27296] being conducted at the Brown University Center for Gerontology and Health Care Research examines how state policies and market forces affect the availability and quality of nursing home care in the US. In addition to the 4 projects being undertaken, one aim of the PPG was to make data on the structure of the US long term care (LTC) system available to potential investigators in a public use form. Brown researchers have compiled data that detail the health and functional status of nursing home residents, the characteristics of care facilities, state long term care reimbursement policies, and the characteristics of markets in which facilities exist for the period 2000 to 2010. The data, currently available on the project website http://ltcfocus.org/, can be used interactively and the entire data base can be down-loaded at the provider, county or state aggregate level, allowing researchers to address their own questions. The site has been visited nearly 20,000 times and the data downloaded by nearly 1000 people so they can explore research questions related to the supply side of the long term care market. In spite of their usefulness to date in understanding provider behavior and documenting temporal and geographic variation in US nursing homes, a whole new class of questions could be addressed were the data linked with individual level data. Since the Health and Retirement Study (HRS) is the largest and longest running national survey of the elderly population, it is an obvious extension of our efforts to make these data available to link them to the HRS. Linking residential information (i.e. zip codes, county or state codes) or provider identification numbers makes it possible to estimate the effect of market and provider characteristics (e.g quality, re-hospitalization, service mix, et.) on individuals' long term care service use choices. Similarly, county level data, such as the number of nursing home beds in the county, and state level policy data, such as the Medicaid payment rate, are available. Indeed, county and state level data can be utilized with HRS data regardless of whether they are also linked to provider files, because they provide contextual information that may influence the choices made by, and outcomes experienced by older adults. The overall goal of this data archiving proposal is to convert LTCFocus into an off the shelf module linkable to HRS restricted data files. The specific aims of this project are to: 1) Update, clean and convert the 2000 to 2010 provider, county and state level LTCFocus data into downloadable files that can be linked with HRS data; 2) Document and prepare a user manual consistent with HRS documentation standards; 3) Test the final product by analyzing HRS restricted files linked to LTCFocus data and revise and deliver the final product to the HRS.