ELDERLY HEALTH AND HEALTH CARE UTILIZATION

随着有关医疗改革的辩论愈演愈烈，关注 把重点放在疾病的代价上，特别是老年人。这个 老年人是我国人口中增长最快的部分 并消耗不成比例的医疗保健资源。本研究 将审查影响健康状况的长期因素和使用 与老年人健康状况不佳和疾病相关的医疗护理。这个 老年人带来了他们一生的社会经济史，这可能是 在确定健康状况和医疗服务使用方面具有重要意义。 我们研究长期因素的影响，如家庭背景， 终生贫困、健康保险和职业历史 健康状况的生命周期模式。要分析医疗保健使用情况， 拟议的研究既考虑了长期因素的直接影响， 以及通过它们对电流的确定所产生的间接影响 私人保险覆盖范围，它们对当前健康的影响，最后 他们对生存的影响一直持续到他们参与 报告医疗费用的调查。内源性健康的影响 医疗服务利用状况由以前的 健康习惯和既往职业健康风险暴露情况。这个 私人保险目前覆盖范围的影响由工作确定 任期、固定工资率、职业、行业和工会成员资格 在上一份/职业生涯最长的工作中，根据详细的工作历史和衡量标准 这些变量来自已婚女性配偶的工作史和 寡妇。选择性生存(或选择性死亡)的影响是 通过婚姻历史上事件的详细时间和时间来识别 个人可在社会保障及发展署内及使用 按性别、种族、年龄和年份分列的死亡率国家重要统计数据。这个 建议的研究使用获得的数据作为特殊健康补充的一部分 由研究小组于1990年指派给PSID，作为原始 计划项目数据获取核心，并作为 PSID公共使用文件。该项目还将使用来自 健康和退休调查。

As the debate concerning health care reform has intensified, attention has focused on the costs of illness, particularly in the elderly. The elderly are the fastest growing segment of the population in our country and consume a disproportionate share of health care resources. This study will examine long-term factors that affect health status and the use of medical care associated with poor health and disease in the elderly. The elderly bring with them a lifetime of socioeconomic history which may be important in determining health status and the use of medical services. We study the effect of long-term factors such as family background, lifetime poverty and health insurance and occupational histories on the life cycle pattern of health status. To analyze medical care use, the proposed research considers both the direct effects of long term factors, as well as the indirect effects through their determination of current private insurance coverage, their effects on current health, and finally their effect on survival to the age at which they participated in the survey to report medical expenditures. The effects of endogenous health status on the utilization of medical services is identified by prior health habits and historical exposure to occupational health risks. The effects of current coverage by private insurance are identified by job tenure, permanent wage rate, occupation, industry and union membership in the last/longest career job from detailed work histories, and measures of these variables from the spouse's work history for married women and widows. The effects of selective survival (or selective mortality) are identified by detailed timing of events in the history of marriage and living arrangements available for individuals in the PSID and by use of national vital statistics on mortality by gender, race, age and year. The proposed study uses data obtained as part of a special health supplement to the PSID in 1990 assigned by the research team as part of the original program project data acquisition core and made available as part of the PSID public use files. The project will also use the AHEAD data from the Health and Retirement Survey.