Essays on Long-Term Care Dynamics

University Of Michigan At Ann Arbor, Ann Arbor MI

Investigators

Linked publications & trials

Abstract

The broad objective of this research is to contribute to the understanding of the complex dynamics of[unreadable] population aging and long-term care. This dissertation research will consist of three distinct but[unreadable] complementary studies that will evaluate different dimensions of these dynamics, with a focus on[unreadable] informal (or unpaid) care, the most common form of long-term care in the U.S. The first proposed[unreadable] study will assess whether, and to what extent, informal care substitutes for paid home care. This[unreadable] study will use a natural experiment that emerged out of the implementation of an Interim Payment[unreadable] System that established payment caps for Medicare home health services in 1997. The main goal of[unreadable] this study is to test whether older adults with functional limitations who lived in states with more[unreadable] restrictive Medicare payment caps compensated for reductions in paid home care with increased[unreadable] informal care. The secondary goal of this first study is to test whether this effect varied by level of[unreadable] income. The second proposed study focuses on the supply of informal care. This study will[unreadable] investigate the effects of women?s labor force participation on the amount of informal care that they[unreadable] deliver and on women?s co-residence with an older parent with functional limitations. To assess the[unreadable] effect of women?s employment on these two outcomes, the research design relies upon natural[unreadable] experiments that arose out of changes in social policies such as the Earned Income Tax Credit and[unreadable] welfare reforms. The third proposed study will extend this analysis to focus on other long-term care[unreadable] outcomes. Because informal care can substitute for other forms of long-term care, I will use a similar[unreadable] methodology to assess whether social policies that affected women?s employment also affected paid[unreadable] home care or nursing home use. This research will illustrate how social policies that do not directly[unreadable] address long-term care or aging may nevertheless have an important impact on health care for older[unreadable] adults.