Pub Date : 2024-07-03Epub Date: 2023-06-23DOI: 10.1080/08959420.2023.2226308
Jae Yeon Lyu, Bo Hu, Raphael Wittenberg, Derek King
Social care is an integral part of the UK welfare system and plays an imperative role in promoting the well-being of older people. This study investigates the impacts of receiving informal social care on formal social care use among community-dwelling older people in England before and after the implementation of the Care Act 2014. Data came from the Health Survey for England for the years 2011 to 2018 (N = 17,292). Bivariate probit models were used to address the endogeneity issue. The analysis shows that receipt of informal care substitutes for formal care. Informal care had a strong substitution effect on formal personal care before 2015, which was significantly weakened after 2015. While the receipt of formal personal care has been increasingly "carer-blind," that of formal domestic care depends on the availability of informal carers and personal affordability, which may result in unmet care needs.
{"title":"The relationships between informal and formal social care for older people in England: A comparison before and after the Care Act 2014.","authors":"Jae Yeon Lyu, Bo Hu, Raphael Wittenberg, Derek King","doi":"10.1080/08959420.2023.2226308","DOIUrl":"10.1080/08959420.2023.2226308","url":null,"abstract":"<p><p>Social care is an integral part of the UK welfare system and plays an imperative role in promoting the well-being of older people. This study investigates the impacts of receiving informal social care on formal social care use among community-dwelling older people in England before and after the implementation of the Care Act 2014. Data came from the Health Survey for England for the years 2011 to 2018 (<i>N</i> = 17,292). Bivariate probit models were used to address the endogeneity issue. The analysis shows that receipt of informal care substitutes for formal care. Informal care had a strong substitution effect on formal personal care before 2015, which was significantly weakened after 2015. While the receipt of formal personal care has been increasingly \"carer-blind,\" that of formal domestic care depends on the availability of informal carers and personal affordability, which may result in unmet care needs.</p>","PeriodicalId":47121,"journal":{"name":"Journal of Aging & Social Policy","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9677180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03Epub Date: 2023-06-26DOI: 10.1080/08959420.2023.2226340
Kylie Meyer, Morgan Zachmeyer, Jane Paccione, Cynthia Cardenas, Carol Zernial, Christina Smith
Family caregivers to persons living with a chronic or disabling condition often report disruption to their employment. Employment disruption can cause long-term financial difficulty and psychological distress for caregivers, high costs for employers, and exacerbates social inequities. In this commentary, we describe a community initiative to better support employees who are caregivers conducted with nonprofit employers in San Antonio, located in the central Texas region of the United States. This initiative aimed to raise awareness among local employers about the challenges employees face in balancing employment and caregiving. This led to the co-development of a pledge to guide employer efforts to support employees who are caregivers. This initiative represents a first step to mobilize employers as stakeholder allies to improve workplace support for family caregivers. The authors draw on the Shilton Model of Policy Advocacy to make the case that the mobilization of employers as advocacy stakeholders can hasten the advancement of policies that enable family caregivers to balance both roles. Further, the implementation of organization-level changes, in addition to state and federal policy changes, to support employed caregivers by employers is consistent with recommendations of the recently published National Strategy to Support Family Caregivers.
慢性病患者或致残者的家庭照顾者经常报告他们的就业受到干扰。就业中断会给照顾者带来长期的经济困难和心理困扰,给雇主带来高昂的成本,并加剧社会不平等。在这篇评论中,我们介绍了美国得克萨斯州中部圣安东尼奥市非营利性雇主为更好地支持员工照顾者而开展的一项社区活动。该倡议旨在提高当地雇主对员工在平衡就业与护理工作时所面临挑战的认识。在此基础上,双方共同制定了一份承诺书,以指导雇主为需要照顾的员工提供支持。该倡议是动员雇主作为利益相关者盟友,改善工作场所对家庭照顾者支持的第一步。作者借鉴了 "希尔顿政策倡导模式"(Shilton Model of Policy Advocacy),认为动员雇主作为倡导利益相关者,可以加快推进使家庭照顾者能够兼顾两种角色的政策。此外,除了州和联邦的政策变化外,雇主实施组织层面的变化以支持受雇的照顾者,这与最近出版的《支持家庭照顾者国家战略》的建议是一致的。
{"title":"A Community Initiative to Engage Employers to Support Caregiving Employees and Build an Advocacy Alliance.","authors":"Kylie Meyer, Morgan Zachmeyer, Jane Paccione, Cynthia Cardenas, Carol Zernial, Christina Smith","doi":"10.1080/08959420.2023.2226340","DOIUrl":"10.1080/08959420.2023.2226340","url":null,"abstract":"<p><p>Family caregivers to persons living with a chronic or disabling condition often report disruption to their employment. Employment disruption can cause long-term financial difficulty and psychological distress for caregivers, high costs for employers, and exacerbates social inequities. In this commentary, we describe a community initiative to better support employees who are caregivers conducted with nonprofit employers in San Antonio, located in the central Texas region of the United States. This initiative aimed to raise awareness among local employers about the challenges employees face in balancing employment and caregiving. This led to the co-development of a pledge to guide employer efforts to support employees who are caregivers. This initiative represents a first step to mobilize employers as stakeholder allies to improve workplace support for family caregivers. The authors draw on the Shilton Model of Policy Advocacy to make the case that the mobilization of employers as advocacy stakeholders can hasten the advancement of policies that enable family caregivers to balance both roles. Further, the implementation of organization-level changes, in addition to state and federal policy changes, to support employed caregivers by employers is consistent with recommendations of the recently published National Strategy to Support Family Caregivers.</p>","PeriodicalId":47121,"journal":{"name":"Journal of Aging & Social Policy","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9692808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03Epub Date: 2022-03-15DOI: 10.1080/08959420.2022.2051683
Sarah E Petry, Luz Lara, Nathan A Boucher
Caregivers play a crucial role in providing health and social supports to their family and friends. Older adults who take on caregiving roles are themselves uniquely vulnerable to negative health and financial effects due to their age and underlying health risks. Many caregivers do not receive adequate support - either formally or informally - exacerbating the strains of providing care. Racial and ethnic minority caregivers may be less likely to report receiving support in their role and face additional challenges. We describe these caregivers over 65 and the burdens they face. We recommend community health workers, direct compensation, and normalization of respite care to support these essential care workers in their role and as they age.
{"title":"Older Caregivers: Who They Are and How to Support Them.","authors":"Sarah E Petry, Luz Lara, Nathan A Boucher","doi":"10.1080/08959420.2022.2051683","DOIUrl":"10.1080/08959420.2022.2051683","url":null,"abstract":"<p><p>Caregivers play a crucial role in providing health and social supports to their family and friends. Older adults who take on caregiving roles are themselves uniquely vulnerable to negative health and financial effects due to their age and underlying health risks. Many caregivers do not receive adequate support - either formally or informally - exacerbating the strains of providing care. Racial and ethnic minority caregivers may be less likely to report receiving support in their role and face additional challenges. We describe these caregivers over 65 and the burdens they face. We recommend community health workers, direct compensation, and normalization of respite care to support these essential care workers in their role and as they age.</p>","PeriodicalId":47121,"journal":{"name":"Journal of Aging & Social Policy","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42569868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-27DOI: 10.1080/08959420.2024.2347807
Allen Glicksman, Misha Rodriguez, Lauren Ring, Philip Lai, Michael Liebman
Older migrants face special difficulties in the access and use of long-term care services and supports (LTSS). Our study was designed to examine how older persons with limited English proficiency (LEP) in two groups of migrants (Spanish or Chinese speaking) interact with the LTSS system. Focus groups were used to elicit information from members of these groups. We discovered Chinese elders were likely to believe that the LTSS services could, if managed properly, meet their needs, while the Spanish speakers were more skeptical. These differences were associated with the presence of trusted intermediaries among the Chinese elders who could represent their interests, while most Spanish speakers did not report having such intermediaries. In this way, trust, or lack of it, was uncovered as the key element defining older adults' interactions with the formal health and social service systems. Findings will be used to develop a modeling method that will allow us to analyze results in a manner that can be extended to use with other migrant groups.
{"title":"Use of Long-Term Care Services by Older Persons with Limited English Proficiency.","authors":"Allen Glicksman, Misha Rodriguez, Lauren Ring, Philip Lai, Michael Liebman","doi":"10.1080/08959420.2024.2347807","DOIUrl":"https://doi.org/10.1080/08959420.2024.2347807","url":null,"abstract":"<p><p>Older migrants face special difficulties in the access and use of long-term care services and supports (LTSS). Our study was designed to examine how older persons with limited English proficiency (LEP) in two groups of migrants (Spanish or Chinese speaking) interact with the LTSS system. Focus groups were used to elicit information from members of these groups. We discovered Chinese elders were likely to believe that the LTSS services could, if managed properly, meet their needs, while the Spanish speakers were more skeptical. These differences were associated with the presence of trusted intermediaries among the Chinese elders who could represent their interests, while most Spanish speakers did not report having such intermediaries. In this way, trust, or lack of it, was uncovered as the key element defining older adults' interactions with the formal health and social service systems. Findings will be used to develop a modeling method that will allow us to analyze results in a manner that can be extended to use with other migrant groups.</p>","PeriodicalId":47121,"journal":{"name":"Journal of Aging & Social Policy","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-13DOI: 10.1080/08959420.2024.2349492
Anna Lyngdal Wulff, Aske Juul Lassen
The retention of older workers has become a key policy issue in European welfare states. Consequently, there is an increased focus on how lifelong learning, or continued competence development, can extend working life. This article explores the dynamics of competence development among employees aged 55 years and older regarding their learning practices and attitudes toward competence development, based on qualitative fieldwork conducted in nine governmental workplaces across Denmark. To gain a comprehensive understanding of the factors that influence willingness to participate in competence development, the article introduces the analytical framework "capacity for competence development" and highlights five factors that influence this capacity: time, economy, learning culture, energy, and purpose. The article argues that (non)participation in competence development is not static and is not solely the responsibility of employees or managers. Rather, it is co-produced by complex workplace dynamics, including policies, age stereotypes, as well as ways of organizing work and learning. In conclusion, the article emphasizes the potential for competence development and suggests that most employees aged 55 years and older want to participate but await the right circumstances. Their participation could be enhanced through an increased focus on the five identified factors in the capacity for competence development.
{"title":"Capacity for Competence Development: Unlocking Potential for Lifelong Learning in Later Working Life.","authors":"Anna Lyngdal Wulff, Aske Juul Lassen","doi":"10.1080/08959420.2024.2349492","DOIUrl":"10.1080/08959420.2024.2349492","url":null,"abstract":"<p><p>The retention of older workers has become a key policy issue in European welfare states. Consequently, there is an increased focus on how lifelong learning, or continued competence development, can extend working life. This article explores the dynamics of competence development among employees aged 55 years and older regarding their learning practices and attitudes toward competence development, based on qualitative fieldwork conducted in nine governmental workplaces across Denmark. To gain a comprehensive understanding of the factors that influence willingness to participate in competence development, the article introduces the analytical framework \"capacity for competence development\" and highlights five factors that influence this capacity: time, economy, learning culture, energy, and purpose. The article argues that (non)participation in competence development is not static and is not solely the responsibility of employees or managers. Rather, it is co-produced by complex workplace dynamics, including policies, age stereotypes, as well as ways of organizing work and learning. In conclusion, the article emphasizes the potential for competence development and suggests that most employees aged 55 years and older want to participate but await the right circumstances. Their participation could be enhanced through an increased focus on the five identified factors in the capacity for competence development.</p>","PeriodicalId":47121,"journal":{"name":"Journal of Aging & Social Policy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-12DOI: 10.1080/08959420.2024.2349480
Chuanqi Que, Haijing Dai
Evidence to date has been inconclusive on the effects of public pension on family support to older adults, and the underlying mechanism behind such effects remains unclear. This study examines the effects of the New Rural Social Pension Scheme on family support to empty-nest older parents in rural China, where family care is traditionally favored for older adults. Using data from the China Longitudinal Aging Social Survey, the findings reveal that pension receipt promotes bidirectional financial transfers and intimate relationships between generations, thus increasing (or crowding in) children's financial and care support to their empty-nest parents. On the other hand, receiving pensions may discourage parental care support to children and partially decrease (or crowd out) children's financial and care support. This crowding-out effect, however, is limited and thus insufficient for counteracting the crowding-in effects from other pathways. Overall, these findings indicate that national welfare, such as pensions, can encourage family support through inter-generational contracts and intimacy, strengthening familial bonds and facilitating mutual assistance within families. For policy implications, government should prioritize improving benefit levels of public pensions to harness the caregiving potential of families and providing essential services that assist families in addressing care burdens.
{"title":"Crowding in or Out?National Public Pension, Inter-Generational Contract, and Family Support to Empty-Nest Older Parents in Rural China.","authors":"Chuanqi Que, Haijing Dai","doi":"10.1080/08959420.2024.2349480","DOIUrl":"10.1080/08959420.2024.2349480","url":null,"abstract":"<p><p>Evidence to date has been inconclusive on the effects of public pension on family support to older adults, and the underlying mechanism behind such effects remains unclear. This study examines the effects of the New Rural Social Pension Scheme on family support to empty-nest older parents in rural China, where family care is traditionally favored for older adults. Using data from the China Longitudinal Aging Social Survey, the findings reveal that pension receipt promotes bidirectional financial transfers and intimate relationships between generations, thus increasing (or crowding in) children's financial and care support to their empty-nest parents. On the other hand, receiving pensions may discourage parental care support to children and partially decrease (or crowd out) children's financial and care support. This crowding-out effect, however, is limited and thus insufficient for counteracting the crowding-in effects from other pathways. Overall, these findings indicate that national welfare, such as pensions, can encourage family support through inter-generational contracts and intimacy, strengthening familial bonds and facilitating mutual assistance within families. For policy implications, government should prioritize improving benefit levels of public pensions to harness the caregiving potential of families and providing essential services that assist families in addressing care burdens.</p>","PeriodicalId":47121,"journal":{"name":"Journal of Aging & Social Policy","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-12DOI: 10.1080/08959420.2024.2348964
Ixchel Pérez-Durán, Alfredo Hernández-Sánchez
This study examines the extent to which general and substantive accountability is integrated into the language used by key actors involved in nursing home services. Particularly, we investigate the messages used by the supply side, which includes public and private organizations involved in residential care for older adults, and the demand side, which comprises organizations representing service beneficiaries. Moreover, we explore the alignment between the messages used by both sides of the accountability relationship. In the context of Spanish nursing homes, we analyzed a corpus of tweets by organizations from both sides of the accountability relationship, from one year before the outbreak of COVID-19 restrictions to after their implementation. Using text analysis techniques, we found that messages related to general and substantive accountability had a low priority before and after the outbreak. Public organizations were slightly more likely to employ general accountability terms than private organizations. This is particularly in non-crisis situations, although less frequently than organizations representing beneficiaries. Our analysis demonstrates a lack of convergence between the messaging on the supply and demand sides, indicating a communication breakdown between the two sides in the accountability relationship.
{"title":"General and Substantive Accountability in Nursing Home Services: Assessing Messages from the Demand Side and the Supply Side.","authors":"Ixchel Pérez-Durán, Alfredo Hernández-Sánchez","doi":"10.1080/08959420.2024.2348964","DOIUrl":"https://doi.org/10.1080/08959420.2024.2348964","url":null,"abstract":"<p><p>This study examines the extent to which general and substantive accountability is integrated into the language used by key actors involved in nursing home services. Particularly, we investigate the messages used by the supply side, which includes public and private organizations involved in residential care for older adults, and the demand side, which comprises organizations representing service beneficiaries. Moreover, we explore the alignment between the messages used by both sides of the accountability relationship. In the context of Spanish nursing homes, we analyzed a corpus of tweets by organizations from both sides of the accountability relationship, from one year before the outbreak of COVID-19 restrictions to after their implementation. Using text analysis techniques, we found that messages related to general and substantive accountability had a low priority before and after the outbreak. Public organizations were slightly more likely to employ general accountability terms than private organizations. This is particularly in non-crisis situations, although less frequently than organizations representing beneficiaries. Our analysis demonstrates a lack of convergence between the messaging on the supply and demand sides, indicating a communication breakdown between the two sides in the accountability relationship.</p>","PeriodicalId":47121,"journal":{"name":"Journal of Aging & Social Policy","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-12DOI: 10.1080/08959420.2024.2348967
Xiyuan Hu, Dianqi Yuan, Yuyu Zeng, Chao Guo
Older adults' access to healthcare services may have been affected by the COVID-19 pandemic. This study explored the effect of the first wave pandemic on the medical expenditure of older adults in China. Difference-in-Difference models captured both temporal and geographical variation in COVID-19 exposure to estimate the impacts of the pandemic on medical expenditure through a quasi-natural experiment. Data derived from the China Family Panel Studies. Results indicate that exposure to the pandemic significantly decreased total medical expenditures, hospital expenditures, and non-hospital medical expenditures of Chinese older adults by 15% (95% CI 12%-17%), 5% (95% CI 2%-7%), and 15% (95% CI 13%-16%), respectively, for each standardized severity increment. Females, less well-educated people, and individuals without internet access were most susceptible to experiencing these reductions. This study revealed that COVID-19 exerted a detrimental influence on the medical expenditure of older adults in mainland China. The "hidden epidemic" of non-COVID-19 medical needs of older adults deserves more attention on the part of policymakers.
COVID-19大流行可能影响了老年人获得医疗服务的机会。本研究探讨了第一波大流行对中国老年人医疗支出的影响。差分模型捕捉了 COVID-19 暴露的时间和地域变化,通过准自然实验估算大流行对医疗支出的影响。数据来源于中国家庭面板研究。结果表明,在每一个标准化严重程度增量中,大流行对中国老年人医疗总支出、住院支出和非住院医疗支出的影响分别显著降低了 15%(95% CI 12%-17%)、5%(95% CI 2%-7%)和 15%(95% CI 13%-16%)。女性、受教育程度较低的人群和无法上网的人群最容易出现上述降幅。这项研究表明,COVID-19 对中国大陆老年人的医疗支出产生了不利影响。老年人非 COVID-19 医疗需求的 "隐性流行病 "值得政策制定者给予更多关注。
{"title":"Impact of the First-Wave COVID-19 Pandemic on Medical Expenditure for Older Adults in China: Lessons from a Natural Experiment.","authors":"Xiyuan Hu, Dianqi Yuan, Yuyu Zeng, Chao Guo","doi":"10.1080/08959420.2024.2348967","DOIUrl":"10.1080/08959420.2024.2348967","url":null,"abstract":"<p><p>Older adults' access to healthcare services may have been affected by the COVID-19 pandemic. This study explored the effect of the first wave pandemic on the medical expenditure of older adults in China. Difference-in-Difference models captured both temporal and geographical variation in COVID-19 exposure to estimate the impacts of the pandemic on medical expenditure through a quasi-natural experiment. Data derived from the China Family Panel Studies. Results indicate that exposure to the pandemic significantly decreased total medical expenditures, hospital expenditures, and non-hospital medical expenditures of Chinese older adults by 15% (95% CI 12%-17%), 5% (95% CI 2%-7%), and 15% (95% CI 13%-16%), respectively, for each standardized severity increment. Females, less well-educated people, and individuals without internet access were most susceptible to experiencing these reductions. This study revealed that COVID-19 exerted a detrimental influence on the medical expenditure of older adults in mainland China. The \"hidden epidemic\" of non-COVID-19 medical needs of older adults deserves more attention on the part of policymakers.</p>","PeriodicalId":47121,"journal":{"name":"Journal of Aging & Social Policy","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-08DOI: 10.1080/08959420.2024.2348426
Ray Van Cleve, Evan Cole, Coleman Drake, Grant Martsolf, Howard Degenholtz
Older people with disabilities living independently often use attendant care, also known as Personal Assistive Services (PAS). The aides providing care can come from a home health agency contracted by the state Medicaid authority, known as agency-directed PAS, or the Medicaid recipient can receive a monthly budget and arrange their own care, known as consumer-directed care. Consumer-directed care is hypothesized to have some possible benefits but could also potentially lead to health hazards. This study examined whether people receiving consumer-directed PAS versus people receiving agency-directed PAS faced a higher risk of hospitalization. The data for this study came from Pennsylvania Medicaid claims, enrollment files, standardized assessments, and hospitalization claims from Medicare and Medicaid. The analysis used two-stage least square regression, with the percentage of people in a county using consumer-directed care as an instrument for the type of PAS. People using consumer-directed care did not have a statistically significant difference in risk for hospitalization compared to people using agency-directed PAS (p = .976). Risk of hospitalization was not different for people using consumer-directed care compared to people using agency-directed care.
独立生活的残疾老年人通常会使用护理员护理,也称为个人辅助服务 (PAS)。提供护理的助手可以来自与州医疗补助机构签订合同的家庭医疗机构,即机构指导的个人辅助服务,也可以由医疗补助受益人按月领取预算并自行安排护理,即消费者指导的护理。据推测,消费者指导型护理可能会带来一些好处,但也有可能导致健康危害。本研究探讨了接受消费者指导型护理的人与接受机构指导型护理的人相比,是否面临更高的住院风险。本研究的数据来自宾夕法尼亚州医疗补助申请、注册档案、标准化评估以及医疗保险和医疗补助的住院申请。分析采用了两阶段最小二乘法回归,以一个县使用消费者指导型护理的人数百分比作为 PAS 类型的工具。与使用机构指导型 PAS 的人相比,使用消费者指导型护理的人在住院风险方面没有显著的统计学差异(p = .976)。与使用机构指导型护理服务的人群相比,使用消费者指导型护理服务的人群的住院风险没有差异。
{"title":"Risk of Hospitalization Associated with Use of Consumer-Directed Attendant Care.","authors":"Ray Van Cleve, Evan Cole, Coleman Drake, Grant Martsolf, Howard Degenholtz","doi":"10.1080/08959420.2024.2348426","DOIUrl":"https://doi.org/10.1080/08959420.2024.2348426","url":null,"abstract":"<p><p>Older people with disabilities living independently often use attendant care, also known as Personal Assistive Services (PAS). The aides providing care can come from a home health agency contracted by the state Medicaid authority, known as agency-directed PAS, or the Medicaid recipient can receive a monthly budget and arrange their own care, known as consumer-directed care. Consumer-directed care is hypothesized to have some possible benefits but could also potentially lead to health hazards. This study examined whether people receiving consumer-directed PAS versus people receiving agency-directed PAS faced a higher risk of hospitalization. The data for this study came from Pennsylvania Medicaid claims, enrollment files, standardized assessments, and hospitalization claims from Medicare and Medicaid. The analysis used two-stage least square regression, with the percentage of people in a county using consumer-directed care as an instrument for the type of PAS. People using consumer-directed care did not have a statistically significant difference in risk for hospitalization compared to people using agency-directed PAS (<i>p</i> = .976). Risk of hospitalization was not different for people using consumer-directed care compared to people using agency-directed care.</p>","PeriodicalId":47121,"journal":{"name":"Journal of Aging & Social Policy","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06DOI: 10.1080/08959420.2024.2348966
Lin Chen, Felicia F Tian, Yu Fu, Eva Kahana
How public policies convey dementia is an important source of the public's understanding of dementia, and newspapers are critical to depicting and disseminating this information to the public. The present study used topic modeling strategies to analyze Chinese newspaper portrayals of dementia from 2005 to 2020 to trace changes in key areas of dementia knowledge in relevant policies. Using WiseNews, the largest Chinese media database, we chose 45 newspapers from mainland China and identified 12,719 articles related to dementia. Using latent Dirichlet allocation (LDA), we performed a topic modeling analysis and identified the six most prevalent topics on dementia across articles: lifestyle recommendations, neighborhood life, foundational scientific research, celebrity and media portrayals, dementia caregiving, and pharmaceutical innovations - all related to the dementia knowledge scale's four dimensions. Findings suggest a steady increase in the number of articles on dementia caregiving and a decline in lifestyle recommendations from 2005 to 2020. However, newspapers continued to stigmatize aging by regularly co-depicting dementia and old age and by using biased terminology. Among the first to investigate dementia's portrayals in mainland Chinese newspapers, this study illuminates the need for expanding mass media campaigns to raise the country's dementia knowledge to foster a dementia-inclusive society.
{"title":"Dementia Knowledge in Chinese Newspapers (2005-2020): A Topic Modeling Analysis.","authors":"Lin Chen, Felicia F Tian, Yu Fu, Eva Kahana","doi":"10.1080/08959420.2024.2348966","DOIUrl":"10.1080/08959420.2024.2348966","url":null,"abstract":"<p><p>How public policies convey dementia is an important source of the public's understanding of dementia, and newspapers are critical to depicting and disseminating this information to the public. The present study used topic modeling strategies to analyze Chinese newspaper portrayals of dementia from 2005 to 2020 to trace changes in key areas of dementia knowledge in relevant policies. Using WiseNews, the largest Chinese media database, we chose 45 newspapers from mainland China and identified 12,719 articles related to dementia. Using latent Dirichlet allocation (LDA), we performed a topic modeling analysis and identified the six most prevalent topics on dementia across articles: lifestyle recommendations, neighborhood life, foundational scientific research, celebrity and media portrayals, dementia caregiving, and pharmaceutical innovations - all related to the dementia knowledge scale's four dimensions. Findings suggest a steady increase in the number of articles on dementia caregiving and a decline in lifestyle recommendations from 2005 to 2020. However, newspapers continued to stigmatize aging by regularly co-depicting dementia and old age and by using biased terminology. Among the first to investigate dementia's portrayals in mainland Chinese newspapers, this study illuminates the need for expanding mass media campaigns to raise the country's dementia knowledge to foster a dementia-inclusive society.</p>","PeriodicalId":47121,"journal":{"name":"Journal of Aging & Social Policy","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}