Advancing Long -Term Care Research by Linking HRS and LTC Focus

描述(由申请人提供)：美国国家医学会资助的塑造长期护理计划项目赠款(PPG)[P0-1-AG-27296]由布朗大学老年学和健康护理研究中心进行，调查国家政策和市场力量如何影响美国养老院护理的可用性和质量。除了正在进行的4个项目外，PPG的一个目标是以公共使用的形式向潜在的调查人员提供关于美国长期护理(LTC)系统结构的数据。布朗研究人员汇编了详细的数据，其中包括疗养院居民的健康和功能状况、护理设施的特征、州长期护理补偿政策以及2000年至2010年期间设施所在市场的特征。目前可以在项目网站http://ltcfocus.org/，上获得的数据可以交互使用，整个数据库可以在提供商、县或州的聚合级别下载，使研究人员能够解决他们自己的问题。该网站的访问量接近2万次，有近1000人下载了数据，因此他们可以探索与长期护理市场供给侧相关的研究问题。尽管到目前为止，它们在理解提供者行为和记录美国养老院的时间和地理变化方面有用，但一类全新的问题可以被解决，即数据与个人水平数据相联系。由于健康和退休研究(HRS)是对老年人口进行的最大规模和持续时间最长的全国性调查，这显然是我们努力提供这些数据以将它们与HRS联系起来的努力的延伸。将住宅信息(即邮政编码、县或州代码)或提供商识别号码联系起来，可以评估市场和提供商特征(例如质量、再次住院、服务组合等)的影响。关于个人长期护理服务的使用选择。同样，县级数据，如该县的养老院床位数量，以及州级政策数据，如医疗补助付款率，都是可用的。事实上，县和州一级的数据可以与HRS数据一起使用，无论它们是否也链接到提供者文件，因为它们提供的背景信息可能会影响老年人所做的选择和所经历的结果。该数据归档提案的总体目标是将LTCFocus转换为可链接到HRS受限数据文件的现成模块。该项目的具体目标是：1)更新、清理2000到2010年的提供者、县和州一级的LTCFocus数据，并将其转换为可下载的文件，以链接到HRS数据；2)记录并编写符合HRS文件标准的用户手册；3)通过分析链接到LTCFocus数据的HRS限制文件来测试最终产品，并修订最终产品并将其交付给HRS。

DESCRIPTION (provided by applicant): The Shaping Long-Term Care in America NIA funded program project grant (PPG) [P0-1-AG- 27296] being conducted at the Brown University Center for Gerontology and Health Care Research examines how state policies and market forces affect the availability and quality of nursing home care in the US. In addition to the 4 projects being undertaken, one aim of the PPG was to make data on the structure of the US long term care (LTC) system available to potential investigators in a public use form. Brown researchers have compiled data that detail the health and functional status of nursing home residents, the characteristics of care facilities, state long term care reimbursement policies, and the characteristics of markets in which facilities exist for the period 2000 to 2010. The data, currently available on the project website http://ltcfocus.org/, can be used interactively and the entire data base can be down-loaded at the provider, county or state aggregate level, allowing researchers to address their own questions. The site has been visited nearly 20,000 times and the data downloaded by nearly 1000 people so they can explore research questions related to the supply side of the long term care market. In spite of their usefulness to date in understanding provider behavior and documenting temporal and geographic variation in US nursing homes, a whole new class of questions could be addressed were the data linked with individual level data. Since the Health and Retirement Study (HRS) is the largest and longest running national survey of the elderly population, it is an obvious extension of our efforts to make these data available to link them to the HRS. Linking residential information (i.e. zip codes, county or state codes) or provider identification numbers makes it possible to estimate the effect of market and provider characteristics (e.g quality, re-hospitalization, service mix, et.) on individuals' long term care service use choices. Similarly, county level data, such as the number of nursing home beds in the county, and state level policy data, such as the Medicaid payment rate, are available. Indeed, county and state level data can be utilized with HRS data regardless of whether they are also linked to provider files, because they provide contextual information that may influence the choices made by, and outcomes experienced by older adults. The overall goal of this data archiving proposal is to convert LTCFocus into an off the shelf module linkable to HRS restricted data files. The specific aims of this project are to: 1) Update, clean and convert the 2000 to 2010 provider, county and state level LTCFocus data into downloadable files that can be linked with HRS data; 2) Document and prepare a user manual consistent with HRS documentation standards; 3) Test the final product by analyzing HRS restricted files linked to LTCFocus data and revise and deliver the final product to the HRS.