UNDERSTANDING RACE DIFFERENCES IN LONG-TERM CARE

继续为残疾老年人提供长期护理。 在融资和交付方面的政策和研究的主要重点 医疗保健。以前的研究已经记录了融资缺口 为老年人提供长期护理服务，严重依赖家庭 会员作为照顾者，和失能老年人的强烈愿望 人们将保持社区居民身份，即使资源用于 以社区为基础的正式长期护理服务往往很少，而且 支离破碎。长期护理“问题”的一个方面 然而，很少有人关注种族或少数群体的作用 会员制。 拟议研究的总体目标是调查 种族在非正式照料安排结构中的作用和使用 正式的居家护理和疗养院护理。这些数据来自 国家长期护理调查，一项具有全国代表性的调查 65岁或以上的残疾人。为了描述该条款的特点， 对黑人残疾老年人的长期护理，而不是他们的白人 作为对口单位，该项目将遵循以下具体目标： 1.描述和比较非正规护理安排的结构 黑人和白人残疾长老。2.检查以下项目的效果 心理社会、语境、经济因素与非正式语言的结构 护理安排，关于长期护理中的黑人/白人差异 利用率。3.调查不同种族在照顾者角色上的差异 以及对照看的认知，以及对正式使用的影响 长期护理服务。 拟议研究的目标是增进我们对 种族在提供长期护理方面的意义。它是 当然，特别重要的是要确定 种族差异反映的是准入障碍，而不是偏好 与文化差异更紧密地联系在一起。通过专注于 与政策相关的变量，如经济资源和背景 保健服务环境指标以及非正规护理 安排和心理社会因素，才有可能开始 了解在使用正式长期护理方面存在种族差异的原因 服务。同样重要的是，这样的分析将澄清 解决种族不平等问题的政策干预。

The provision of long-term care to disabled older people continues to be a major focus of policy and research in the financing and delivery of health care. Previous research has documented the gaps in financing long-term care services for older people, the heavy reliance on family members as providers of care, and the strong desire of disabled older people to remain community-resident even though resources for community-based formal long-term care services are often meager and fragmented. One aspect of the long-term care "problem" that has received little attention, however, is the role of race or minority-group membership. The overall objective of the proposed research is to investigate the role of race in the structure of informal caregiving arrangements and the use of formal inhome care and nursing home care. The data are from the National Long-Term Care Surveys, a nationally representative survey of disabled people age 65 or older. In order to characterize the provision of long-term care to black disabled elders, in contrast to their white counter parts, the project will be guided by the following specific aims: 1. To describe and compare the structure of informal care arrangements of black and white disabled elders. 2. To examine the effects of psychosocial, contextual, economic factors and the structure of informal care arrangements, on black/white differences in long-term care utilization. 3. To investigate differences by race in the caregiver role and in perceptions of caregiving, and the effects on use of formal long-term care services. The goal of the proposed research is to advance our understanding of the significance of race in the provision of long-term care. It is particularly important, of course, to determine the extent to which differences by race reflect barriers to access as opposed to preferences that are more closely tied to cultural differences. By focusing on policy-related variables, such as economic resources and contextual indicators of the health services environment, as well as informal care arrangements and psychosocial factors, it is possible to begin to understand the causes of race differences in use of formal long-term care services. Equally important, such analyses will clarify the need for policy interventions to address racial inequities.