Estimating the Demand for Medicaid Financial Long-Term Care for the Elderly

描述（由申请人提供）：K 01奖的申请是为了促进Arpita Chattopadhyay博士过渡到老龄化和长期护理流行病学领域的独立调查员，重点是医疗补助政策。她的长期目标是开发一个跨学科的计划，将老龄化和残疾的生物医学研究与经济学和社会学中的行为研究联系起来，重点是老年人长期护理的利用和融资。培训目标是：（1）获得老龄化和长期护理政策的社会学和经济学方面的实质性知识;（2）获得开发残疾随机模型的新技能;（3）开发评估残疾决定因素的框架，长期护理使用和融资。指导团队包括经验丰富的卫生服务研究员Andrew Bindman博士、长期护理问题专家Robert Newcomer博士和Charlene哈灵顿博士、慢性病建模随机过程专家Peter Bacchetti博士以及专门研究老龄人口统计学的Ronal Lee博士 尚未研究改变种族和民族构成对长期护理需求和利用医疗补助资助长期护理的影响。这项研究将克服这一缺点，将种族和民族纳入预测模型的长期护理需求和医疗补助使用的老年人。该研究将解决NIA的两个优先领域，即老龄化和卫生/医疗保健差距以及卫生系统的效率。利用抽样调查和行政来源的服务使用的数据，本研究提出了四个具体的目标，对应于未来长期护理使用和融资的四个结构性决定因素。目标1将确定特定年龄残疾患病率的种族和族裔差异。目标2将确定特定残疾程度的长期护理的特定年龄使用的种族和民族差异。目标3将确定残疾老年人使用医疗补助的种族和民族差异。目标1-3，然后将被合并，并用于获得随机预测的老年医疗补助受益人在长期护理（目标4）。一个详细的微观模拟模型，结合使用医疗补助资助的长期护理的行为和结构的决定因素，将提出一个R 01项目在K 01结束。

DESCRIPTION (provided by applicant): This application for a K01 award is to facilitate Dr. Arpita Chattopadhyay's transition to an independent investigator in the field of epidemiology of aging and long-term care with a focus on Medicaid policy. Her long-term goal is to develop an interdisciplinary program linking biomedical research on aging and disability with behavioral research in economics and sociology that focuses on utilization and financing of long-term care among the elderly. The training goals are (1) to acquire substantive knowledge in sociology and economics of aging and long-term care policies; (2) to acquire new skills in developing stochastic models of disability; and (3) to develop a frame work for estimating the determinants of disability, long-term care use, and financing. The mentoring team includes Dr. Andrew Bindman, an experienced health services researcher; Drs. Robert Newcomer and Charlene Harrington, experts in long-term care issues; Dr. Peter Bacchetti, expert in stochastic processes in chronic disease modeling; and Dr. Ronal Lee, who specializes in the demography of aging The impact of changing racial and ethnic composition on the demand for long-term care and utilization of Medicaid for financing long-term care has not been studied. This research will overcome this shortcoming by incorporating race and ethnicity into projection models for long-term care demand and Medicaid use among the elderly. The research will address two of the priority areas at the NIA, namely aging and health /healthcare disparities and efficiency of the health system. Drawing upon data from sample surveys and administrative sources on service use, this research proposes four specific aims that correspond to four structural determinants of future long-term care use and financing. Aim 1 will determine racial and ethnic differences in age-specific prevalence of disability. Aim 2 will determine racial and ethnic differences in age specific use of long-term care for a given level of disability. Aim 3 will determine the racial and ethnic differences in use of Medicaid among the disabled elderly. Aims 1-3 will then be combined and used to obtain stochastic projection of elderly Medicaid beneficiaries in long-term care (Aim 4). A detailed microsimulation model incorporating behavioral and structural determinants of using Medicaid financed longterm care will be proposed for an R01 project at the end of the K01.