Abstract:
OBJECTIVE:To estimate the total hours of paid and unpaid personal assistance of daily living provided to adults living at home in the United States using nationally representative household survey data. DATA SOURCES:The Disability Followback Survey of the National Health Interview Survey on Disability (NHIS-D) conducted from 1994 to 1997. DATA COLLECTION/EXTRACTION METHODS:Data were obtained on persons receiving help with up to 5 ADLs and 10 IADLs, for up to 4 helpers, including the activities they helped with, whether the helper was paid or not, and the number of hours of help provided in the two weeks prior to the survey. The sample consists of 8,471 household-resident adults ages 18 and older receiving help with personal assistance. About 22 percent of the sample has missing data on hours, which we impute by multiple regression models using demographic, ADL, and IADL variables. FINDINGS:We estimate that 13.2 million noninstitutionalized adults receive an average of 31.4 hours per week of personal assistance in ADLs and IADLs per week, with 3.2 million people receiving an average of 17.6 hours of paid help and 11.7 million receiving an average of 30.7 hours of unpaid help. More persons ages 18-64 received help than those ages 65 and older (6.9 versus 6.2 million), but working-age recipients had fewer hours (27.4 versus 35.9) per week, due in part to less severe levels of disability. CONCLUSIONS:Personal assistance provided to adults with disabilities amounts to 21.5 billion hours of help per year, with an economic value in 1996 approaching $200 billion. Only 16 percent of this total is paid, representing $32 billion in home health services spent annually. This study, the first to estimate hours of assistance for both working-age and older adults, documents that older persons are more likely to receive paid personal assistance, while working-age people rely to a greater extent on unpaid help. This study begins to articulate the division of labor in the provision of personal assistance. Estimates of paid and unpaid hours of help by number of ADLs should inform policy concerning eligibility boundaries in long term care.
journal_name
Health Serv Resjournal_title
Health services researchauthors
LaPlante MP,Harrington C,Kang Tdoi
10.1111/1475-6773.029keywords:
subject
Has Abstractpub_date
2002-04-01 00:00:00pages
397-415issue
2eissn
0017-9124issn
1475-6773journal_volume
37pub_type
杂志文章abstract:OBJECTIVE:To examine changes in children's albuterol use and out-of-pocket (OOP) costs in response to increased copayments after the Food and Drug Administration banned inhalers with chlorofluorocarbon (CFC) propellants. SETTING:Four health maintenance organizations (HMOs), two that increased copayments for albuterol ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12615
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To investigate whether a performance-based contracting (PBC) system provides incentives for nonprofit providers of substance abuse treatment to select less severe clients into treatment. DATA SOURCES:The Maine Addiction Treatment System (MATS) standardized admission and discharge data provided by the Maine O...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00132
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:To examine the effect of Medicaid expansions on health insurance coverage and access to care among low-income adults with behavioral health conditions. DATA SOURCES/STUDY SETTING:Nine years (2004-2012) of individual-level cross-sectional data from a restricted-access version of National Survey on Drug Use an...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12411
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVES:To assess the relative abilities of clinical and administrative data to predict mortality and to assess hospital quality of care for CABG surgery patients. DATA SOURCES/STUDY SETTING:1991-1992 data from New York's Cardiac Surgery Reporting System (clinical data) and HCFA's MEDPAR (administrative data). STUD...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1997-02-01 00:00:00
abstract:OBJECTIVE:This commentary summarizes the methods and topics addressed in the special issue of HSR focused on linkage of United States Department of Veterans Affairs (VA) and non-VA datasets. The issue illustrates that researchers are increasingly linking diverse datasets as a valuable method for obtaining outcomes, tre...
journal_title:Health services research
pub_type:
doi:10.1111/1475-6773.13081
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To provide guidance on improving the quality of case studies in health services research. DATA SOURCES:Secondary data, drawing from previous case study research. RESEARCH DESIGN:Guidance is provided to two audiences: potential case study investigators (eight items) and reviewers of case study proposals (fou...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:
更新日期:1999-12-01 00:00:00
abstract::In late 1982, as an alternative to Medicaid, Arizona implemented a prepaid, competitively bid medical care program--the Arizona Health Care Cost Containment System (AHCCCS). Before its introduction, the poor had been cared for primarily by a network of county-supported centers. Impact of the AHCCCS initiative was exam...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1985-08-01 00:00:00
abstract:OBJECTIVE:We evaluate the impact of membership in a staff-model health maintenance organization (HMO) on hospital admission rates for patients presenting to an emergency department with acute chest pain. DATA SOURCES AND STUDY SETTING:Primary prospective data were gathered from all 3,006 patients presenting with a chi...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVE:To test for differences in patient outcomes when hospital and post-acute care (PAC) providers participate in accountable care organizations (ACOs). DATA/SETTING:Using Medicare claims, we examined changes in readmission, Medicare spending, and length of stay among patients admitted to ACO-participating hospit...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13023
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To determine whether Medicare enrollment at age 65 has an effect on the health trajectory of the near-elderly uninsured. DATA SOURCES:Eight biennial waves (1992-2006) of the Health and Retirement Study, a nationally representative panel survey of noninstitutionalized 51-61 year olds and their spouses. STUDY...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2009.00964.x
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. DATA SOURCES:The primary data sources are the Medicare Cost Reports for 1998-2004 and hospital inpatient discharge data for three of the states where single sp...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2008.00881.x
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To examine the impact of the Short Stay Transfer Policy (SSTP) on practice patterns. DATA SOURCES:This study uses data from the Centers for Medicare and Medicaid Services Medicare Provider Analysis and Review (MEDPAR) file, Home Health Standard Analytical File, 1999 Provider of Service file, and data from th...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00606.x
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To summarize the state of the art in quality improvement, review its application to care for children, and define the information that will be needed so that care for children can be further improved. PRINCIPAL FINDINGS:Health services for children exhibit numerous deficiencies in quality of care. The defici...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:
更新日期:1998-10-01 00:00:00
abstract::Properties of the inverse gaussian distribution are presented with comments on fitting the distribution to lentgh-of-stay data. A conceptual framework for the hospitalization process is described; it suggests that the inverse gaussian distribution has considerable potential as both a descriptive and prescriptive model...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1975-10-01 00:00:00
abstract:OBJECTIVE:To discuss and quantify the incentives that Medicare managed care plans have to avoid (through selective enrollment or disenrollment) people who are at risk for very high costs, focusing on Medicare beneficiaries in the last year of life-a group that accounts for more than one-quarter of Medicare's annual exp...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00218.x
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:To examine the relationship between features of managed care organizations (MCOs) and health care use patterns by children. DATA SOURCES:Telephone survey data from 2,223 parents of children with special health care needs, MCO-administrator interview data, and health care claims data. STUDY DESIGN:Cross-sect...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2003.00195.x
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:To assess the relative impact of clinical factors versus nonclinical factors-such as postacute care (PAC) supply-in determining whether patients receive care from skilled nursing facilities (SNFs) or inpatient rehabilitation facilities (IRFs) after discharge from acute care. DATA SOURCES AND STUDY SETTING:Me...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00365.x
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVE:To examine the source of observed lower risk-adjusted mortality for blacks than whites within the Veterans Affairs (VA) system by accounting for hospital site where treated, potential under-reporting of black deaths, discretion on hospital admission, quality improvement efforts, and interactions by age group....
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00688.x
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:To estimate 2012 tax expenditures for employer-sponsored insurance (ESI) in the United States and to explore the sensitivity of estimates to assumptions regarding the incidence of employer premium contributions. DATA SOURCES:Nationally representative Medical Expenditure Panel Survey data from the 2005-2007 H...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12037
更新日期:2013-04-01 00:00:00
abstract:RESEARCH OBJECTIVE:This study examines small area variations in readmission rates to assess whether higher readmission rate in an area is associated with higher clusters of patients with multiple chronic conditions. STUDY DESIGN:The study uses hospital discharge data of adult (18+) patients in 6 U.S. states for 2009 f...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12401
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:To understand reasons why California has lower Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores than the rest of the country, including differing patterns of CAHPS scores between Medicare Advantage (MA) and fee-for-service, effects of additional demographic characteristics of beneficiari...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01279.x
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To assess the issue of nonrepresentative sampling in Medicare Advantage (MA) risk adjustment. DATA SOURCES:Medicare enrollment and claims data from 2008 to 2011. DATA EXTRACTION:Risk adjustment predictor variables were created from 2008 to 2010 Part A and B claims and the Medicare Beneficiary Summary File. ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13046
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:The volume and cost of services consumed by persons with AIDS (PWAs) during their last months of life are examined in this study. DATA SOURCES:This study utilizes data from the AIDS Costs and Service Utilization Survey (ACSUS). The ACSUS is the most comprehensive survey of medical services that are consumed ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:Racial and ethnic disparities in health and health care have been documented; the elimination of such disparities is currently part of a national agenda. In order to meet this national objective, it is necessary that measures identify accurately the true prevalence of the construct of interest across diverse...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:10.1111/j.1475-6773.2005.00450.x
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:To assess the effectiveness and cost-effectiveness of four treatment modalities for substance abuse. DATA SOURCES:The study used data from the Services Research Outcomes Study (SROS), a survey of 3,047 clients in a random sample of 99 drug treatment facilities across the United States. Detailed sociodemograp...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00114
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to assess nonresponse error in telephone health survey data based on an address-based sample. DATA SOURCES:Telephone and in-person interviews in Greater Boston. STUDY DESIGN/DATA COLLECTION:Interviewers attempted telephone interviews at addresses that were matched to telephon...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13110
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:Apply quantile regression for a high-resolution analysis of changes in wait time to treatment and assess its applicability to quality improvement data compared with least-squares regression. DATA SOURCE:Addiction treatment programs participating in the Network for the Improvement of Addiction Treatment. MET...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01436.x
更新日期:2013-02-01 00:00:00
abstract::The planning, budgeting, and controlling processes (PBCP) largely subsume all of the planning and controlling activities of an organization. This paper discusses these activities within the context of a single management control system, focusing on three topics. First, a brief historical perspective of management conc...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract:OBJECTIVE:To examine measures of need for health care and their relationship to utilization of health services in different racial and ethnic groups in California. DATA SOURCE:Telephone interviews obtained by random-digit dialing and conducted between April 1993 and July 1993 in California, with 7,264 adults (ages 18-...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVE:To examine the settings of simulation evidence supporting use of nonlinear two-stage residual inclusion (2SRI) instrumental variable (IV) methods for estimating average treatment effects (ATE) using observational data and investigate potential bias of 2SRI across alternative scenarios of essential heterogenei...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12463
更新日期:2016-12-01 00:00:00