Operational Definition of Chronic Disability in the National Long-Term Care Surve

摘要：本申请申请为期两年的资金，用于调查国家长期护理调查（NLTCS）中慢性残疾的操作定义。已发表的研究使用了NLTCS的数据或参考了NLTCS的结果，这些研究提供的关于调查所使用的慢性残疾定义的细节数量各不相同。然而，这些研究大多忽略了调查的纵向特征，过度简化了NLTCS对慢性残疾的操作定义。这种做法不仅可能导致错误的结论，而且还可能导致错误的政策含义。NLTCS始于1982年，到2004年已经延续了六波。它提供了一个重要的信息来源，说明随着时间的推移，美国老年人的残疾可能发生的变化。NLTCS关于日常生活基本活动和工具性活动的数据已被用于产生一些重大发现，例如显示美国老年人慢性残疾的下降。然而，设计的复杂性受到调查早期许多决策的影响，给NLTCS数据的二级用户带来了概念和分析上的挑战。特别是，NLTCS使用的慢性残疾的操作定义很难全面追踪。因此，它经常被误解为过度简化。我们的初步研究表明，NLTCS通过设计测量慢性和短期残疾的某种组合，而不是文献中通常所说的慢性残疾。该项目的主要目的是对NLTCS中使用的慢性残疾的操作定义进行全面描述，并调查NLTCS所做的设计选择对慢性残疾测量的影响。本项目将阐明慢性残疾的基本定义（残疾持续时间超过90天）与NLTCS复杂的纵向设计之间的相互作用。它还将调查是否有老年人口的亚组受到NLTCS设计选择的不同影响，因为它们与慢性残疾的测量有关。最后，本文将探讨来自NLTCS的额外数据是否可以用于获得有效的慢性残疾测量。这项研究的结果将有利于NLTCS数据的二次使用者和未来旨在追踪老年人慢性残疾状况的纵向调查的设计者。国家长期护理调查项目叙述中慢性残疾的操作定义：本申请要求两年的资金来调查国家长期护理调查（NLTCS）中慢性残疾的操作定义。已发表的研究使用了NLTCS的数据或参考了NLTCS的结果，这些研究提供的关于调查所使用的慢性残疾定义的细节数量各不相同。然而，这些研究大多忽略了调查的纵向特征，过度简化了NLTCS对慢性残疾的操作定义。这种做法不仅可能导致错误的结论，而且还可能导致错误的政策含义。该项目的主要目的是对NLTCS中使用的慢性残疾的操作定义进行全面描述，并调查NLTCS所做的设计选择对慢性残疾测量的影响。本项目将阐明慢性残疾的基本定义（残疾持续时间超过90天）与NLTCS复杂的纵向设计之间的相互作用。它还将调查是否有老年人口的亚组受到NLTCS设计选择的不同影响，因为它们与慢性残疾的测量有关。最后，本文将探讨来自NLTCS的额外数据是否可以用于获得有效的慢性残疾测量。这项研究的结果将有利于NLTCS数据的二次使用者和未来旨在追踪老年人慢性残疾状况的纵向调查的设计者。

DESCRIPTION (provided by applicant): Operational definition of chronic disability in the National Long-Term Care Survey Abstract: This application requests two years of funding to investigate the operational definition of chronic disability in the National Long-Term Care Survey (NLTCS). Published studies that use data or refer to results from the NLTCS vary in the amount of detail they provide on the definition of chronic disability employed by the survey. Most of these studies, however, oversimplify the NLTCS's operational definition of chronic disability by ignoring longitudinal features of the survey. This practice may lead not only to erroneous conclusions but also to misspecified policy implications. The NLTCS began in 1982 and now extends over six waves through 2004. It provides an important source of information on possible changes in disability over time among the elderly Americans. The NLTCS data on basic and instrumental activities of daily living have been used to generate some major findings such as showing a decline in chronic disability among the elderly Americans. However, complexity of the design, influenced by many decisions made in the early years of the survey, presents conceptual and analytic challenges for secondary users of the NLTCS data. In particular, the operational definition of chronic disability employed by the NLTCS is difficult to track down comprehensively. As a result, it often gets misinterpreted toward an oversimplification. Our preliminary study shows that the NLTCS by design measures some combination of chronic and short term disability as opposed to chronic disability as commonly stated in the literature. The primary aims of this project are to develop a comprehensive description of the operational definition of chronic disability used in the NLTCS and to investigate the impact of the design choices made by the NLTCS on the measurement of chronic disability. This project will illuminate the interplay between the basic definition of chronic disability, as a disability lasting more than 90 days, and the complex longitudinal design of the NLTCS. It will also investigate whether there are subgroups of the elderly population that are differentially affected by the NLTCS design choices as they relate to the measurement of chronic disability. Finally, it will explore whether additional data from the NLTCS can be used to obtain a valid chronic disability measure. Findings of this study will benefit secondary users of the NLTCS data and future designers of longitudinal surveys that aim to track chronic disability status of the elderly over time. Operational definition of chronic disability in the National Long-Term Care Survey Project Narrative: This application requests two years of funding to investigate the operational definition of chronic disability in the National Long-Term Care Survey (NLTCS). Published studies that use data or refer to results from the NLTCS vary in the amount of detail they provide on the definition of chronic disability employed by the survey. Most of these studies, however, oversimplify the NLTCS's operational definition of chronic disability by ignoring longitudinal features of the survey. This practice may lead not only to erroneous conclusions but also to misspecified policy implications. The primary aims of this project are to develop a comprehensive description of the operational definition of chronic disability used in the NLTCS and to investigate the impact of the design choices made by the NLTCS on the measurement of chronic disability. This project will illuminate the interplay between the basic definition of chronic disability, as a disability lasting more than 90 days, and the complex longitudinal design of the NLTCS. It will also investigate whether there are subgroups of the elderly population that are differentially affected by the NLTCS design choices as they relate to the measurement of chronic disability. Finally, it will explore whether additional data from the NLTCS can be used to obtain a valid chronic disability measure. Findings of this study will benefit secondary users of the NLTCS data and future designers of longitudinal surveys that aim to track chronic disability status of the elderly over time.