Effects of Informal Care for persons with Alzheimer's Disease and related dementias

非正式护理对阿尔茨海默病和相关痴呆症患者的影响

基本信息

批准号：
9928566
负责人：
Norma B Coe
金额：
$ 6.71万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-30 至 2021-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9928566
关键词：
Address Advocate Age Alzheimer&apos s disease related dementia American Area Assisted Living Facilities Budgets Care given by nurses Caregivers Caring Clinical Communities Cost of Illness Country Data Data Set Databases Dedications Direct Costs Disease Economics Effectiveness Elderly Emergency department visit Emotional Evaluation Experimental Designs Facilities and Administrative Costs Family Financial Hardship Formal caregiver Friends Goals Government Financing Health Health Resources Health and Retirement Study Healthcare Home Nursing Care Home environment Hospitalization Independent Living Individual Industry Intuition Long-Term Care Longevity Measures Medicaid Medicare Medicare/Medicaid Memory Mental Health Methods Nature Nursing Homes Outcome Patient Self-Report Patients Persons Play Policies Population Prevalence Privatization Psyche structure Research Residential Treatment Resources Retirement Role Sampling Science Severity of illness Source Techniques Training Work aged care costs care outcomes care providers care recipients cost disability experience functional disability health care availability health care service utilization informal care informal caregiver informal support instrument patient oriented person centered physical conditioning psychologic social trend

项目摘要

Effects of Informal Care for persons with Alzheimer's Disease and Related Dementias The current debate about how best to meet the growing demand for patient-centered, high-quality long- term care for persons with ADRD in the least restrictive setting possible has centered almost solely on the direct and indirect costs of each type of care. A crucial missing piece is a comparison of the benefits. While receiving informal care may seem intuitively appealing, we currently know surprisingly little about the implications of this choice for outcomes of the individuals receiving the care. Our study would be the first to measure the causal impact of receiving informal versus formal long-term care on key and multi-faceted outcomes for the care recipient, primarily using the Health and Retirement Study, a nationally-representative dataset of Americans age 50+. Our analysis would include all individuals receiving long-term care, as well as a sub-sample of individuals living with ADRD, since informal care costs account for approximately half the total costs of the disease. Our health outcomes include a rich set of self-reported physical, mental, emotional, and social health measures, as well as self-reported and administrative health care utilization measures. In order to estimate the causal impact of formal and informal care, we employ instrumental variable techniques and a set of instruments that have been successfully used to predict informal care receipt in previous work using the same dataset. In addition, we propose new and promising instruments, including the supply of formal care available in the market. Finally, our study is the first to take a comprehensive look at all forms of formal care, including the plethora of private-pay residential care options. To do so, this research brings together the Area Health Resource Files (AHRF) and the NIC-MAP database, the industry's premiere dataset concerning the long-term care market. Using this approach, our study proposes to address the following specific aims: to describe comprehensively an expanded profile of the supply of publicly and privately financed formal care in local markets and its correlation with informal care, and to quantify the difference in care recipient outcomes caused by receiving informal versus formal care. This proposal will inform the policy tradeoffs between supporting informal care providers and expanding publicly financed formal care options.

非正式护理对患有阿尔茨海默氏病和相关痴呆症患者的影响当前关于如何最好地满足对以患者为中心的高质量长期需求不断增长的辩论在最小限制性设置中，对ADRD的人的期限照顾几乎完全集中在直接上和每种护理的间接成本。至关重要的缺失是对好处的比较。收到的同时非正式护理似乎很吸引人，我们目前对此的影响却一无所知选择接受护理的个人的结果。我们的研究将是第一个衡量接收非正式与正式长期因果关系的影响护理接受者的关键和多方面结果的护理，主要使用健康和退休研究，一个全国代表性的美国人50岁以上的数据集。我们的分析将包括所有接受的人长期护理以及ADRD的个人子样本，因为非正式护理费用为大约是疾病总成本的一半。我们的健康成果包括一套丰富的自我报告的身体，精神，情感和社会健康措施，以及自我报告和行政保健利用措施。为了估计正式和非正式护理的因果影响，我们采用仪器变量技术和一套已成功用于预测非正式护理收据的工具使用同一数据集进行工作。此外，我们提出了新的和有前途的乐器，包括市场上可用的正式护理。最后，我们的研究是第一个对所有形式进行全面研究的研究正式护理，包括大量的私人付费住宅护理选择。为此，这项研究汇集了区域健康资源文件（AHRF）和NIC-MAP数据库，该行业的首映数据集长期护理市场。使用这种方法，我们的研究建议解决以下特定目的：描述全面扩展了在当地市场上公开和私人融资的正式护理供应的概况及其与非正式护理的相关性，并量化由接受非正式和正式护理。该提案将为支持非正式的政策权衡提供信息护理提供者并扩大了公开融资的正式护理选择。