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

其他项目信息-项目摘要/摘要 劳动力市场状况与老年人长期护理质量 美国人口迅速老龄化，阿尔茨海默病和相关痴呆症的高发病率 (ADRD)预计将导致对长期护理(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有尊严地变老将需要 拥有庞大的高素质LTC劳动力队伍。然而，低工资，加上要求很高的工作，使得很难 填补疗养院护理助理和家庭保健助理的现有职位。这就提高了 对劳动力在美国长期培训质量持续较低中所扮演的角色以及 目前LTC工人的供应满足未来的需求。政策制定者有许多工具来影响 LTC劳动力的质量和数量，但缺乏关于具体影响的经验证据 这些政策杠杆影响长期培训人员的规模和性质，或长期培训交付给 上了年纪的人。在很长一段时间内(1999-2018)广泛使用不同的劳动力市场政策 来自CMS的结果数据，我们将解决几个重要的问题，即政府政策如何 可能会影响LTC劳动力和老年人的结果。该项目有四个具体目标。目标1，审查 州LTC工人法规对LTC质量的影响，审查了专门针对 LTC部门，包括疗养院和家庭助理的最低培训要求和最低人员配置 对养老院的要求。目标2，评估政府劳动力市场政策如何影响长期培训质量， 评估三个联邦和州的最低工资、劳动所得税收抵免和儿童保育税收抵免 已被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，首先记录了移民流动对规模的影响 无论是在养老院还是在人们的家中，LTC劳动力的数量，然后使用工具变量 检查移民工人数量的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，这是一个群体 严重依赖长期培训，可能会特别受到长期培训员工变化的影响，因为他们的 脆弱性和可能需要专门护理。综上所述，这组分析将提供一种新颖的 通过这个镜头来观察政府劳动力市场政策，这些政策推动了LTC的数量和质量。结果 可以为基于证据的政策制定提供信息，旨在促进足够的劳动力来满足国家的 对LTC服务的需求不断增加。

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.