The Effects of the Affordable Care Act Medicaid Expansion on Informal Care

《平价医疗法案》医疗补助扩展对非正式医疗的影响

基本信息

批准号：
10351420
负责人：
Yang Wang
金额：
$ 29.77万
依托单位：
UNIVERSITY OF WISCONSIN-MADISON
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-15 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10351420
关键词：
Address Adult Affect Affordable Care Act Age Alzheimer&apos s Disease Alzheimer&apos s disease related dementia American Caregivers Caring Chronic Disease Costs and Benefits Data Set Diagnosis Education Elderly Ethnic Origin Evaluation Failure Family Financial cost Friends Funding Future Gender Goals Health Health Insurance Health and Retirement Study Healthcare Systems Individual Insurance Coverage Knowledge Lead Life Life Expectancy Literature Long-Term Care Low income Marital Status Measures Medicaid Medicare Mental Health Methods National Institute on Aging Outcome Patients Pattern Persons Policies Population Prevention Probability Public Health Publications Race Research Security Stress Surveys Testing Time Translating United States National Institutes of Health Ursidae Family aged care recipients cost cost effective design experience health care service utilization improved informal care informal caregiver informal support insight interest physical conditioning policy implication pressure programs psychologic time use

项目摘要

Abstract Over 70 percent of older adults aged 65 or older require assistance from caregivers with basic functions at some point in their lifetime, and most of that care is provided informally by families and friends. These informal caregivers, especially those to older adults with Alzheimer’s disease and Alzheimer’s disease-related dementias (AD/ADRD), bear huge physical, phycological, and financial costs which limit their ability to provide care. The most recent Medicaid expansion under the Patient Protection and Affordable Care Act (ACA-ME) has been shown to substantially increase health insurance coverage and health care utilization, improve enrollees’ physical and mental health and financial security, and influence their labor market outcomes. All these effects could be potential mechanisms through which the ACA-ME impacts informal care. However, despite the large number of studies on ACA-ME, little is known about its effects on informal care for older adults. We propose to fill this gap by examining the effects of the ACA-ME on informal care provided to and received by older adults. Specifically, we will use a difference-in-differences approach and compare informal care provision and receipt among individuals living in states that expanded their Medicaid program before and after the expansion relative to the change in informal care provision and receipt experienced by comparable individuals living in non-expansion states over the same period. We will use the American Time Use Survey to measure informal care provided by low-income adults aged 18 to 64 who are most likely to be affected by the ACA-ME. We will use the Health Retirement Study to measure informal care received by older adults. By considering this spillover effect of the ACA-ME on informal care, the proposed project will be important for policymakers interested in designing more effective policies to sustain or even increase the supply of informal care to meet the escalating demand and for those interested in a more comprehensive evaluation of the ACA- ME.

抽象的超过 70% 的 65 岁或以上老年人需要具备基本功能的护理人员的帮助他们一生中的某个时刻，大部分护理是由家人和朋友非正式提供的。护理人员，尤其是患有阿尔茨海默病和阿尔茨海默病相关的老年人的护理人员痴呆症（AD/ADRD）承受着巨大的身体、心理和财务成本，这限制了他们提供治疗的能力根据《患者保护和平价医疗法案》(ACA-ME)，最新的医疗补助扩展。已被证明可以大幅提高医疗保险覆盖率和医疗保健利用率，改善登记者的身心健康和财务安全，并影响他们的劳动力市场结果。这些影响可能是 ACA-ME 影响非正式护理的潜在机制。尽管对 ACA-ME 进行了大量研究，但对其对老年人非正式护理的影响知之甚少。我们建议通过研究 ACA-ME 对向成人提供的非正式护理的影响来填补这一空白。具体来说，我们将使用双重差异法并比较非正式的。居住在之前和之后扩大医疗补助计划的州的个人的护理提供和接收相对于可比较的非正规护理提供和接受的变化而言，扩张之后我们将使用美国时间使用调查来了解同期居住在非扩张州的个人。衡量 18 至 64 岁低收入成年人提供的非正式护理，他们最有可能受到 ACA-ME。我们将使用健康退休研究来衡量老年人接受的非正式护理。考虑到 ACA-ME 对非正式护理的溢出效应，拟议的项目对于政策制定者有兴趣设计更有效的政策来维持甚至增加非正规就业的供应关心满足不断增长的需求以及对 ACA 进行更全面评估感兴趣的人我。