家庭和社区服务的使用是否会减少残疾老年人的医院利用率和医院支出? 来自中国的证据
Yanling Yi1, Junxia Liu1, Ling Jiang1
1School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China.
Frontiers in public health
|November 15, 2023
概括
家庭和社区服务 (HCBS) 显著减少了残疾老人的医院使用和成本,改善了他们的健康状况. 政策应该优先考虑HCBS的可访问性和弱势群体的服务.
科学领域:
- 老年学和卫生服务研究研究
- 长期护理政策与经济 长期护理政策与经济
背景情况:
- 家庭和社区服务 (HCBS) 对安居老龄化和长期护理 (LTC) 的安全至关重要.
- HCBS对残疾老年人医院利用率和支出的影响仍然不确定.
研究的目的:
- 调查HCBS使用对残疾老年人医院利用率和支出的因果关系.
- 确定HCBS对这一群体的潜在机制和异质影响.
主要方法:
- 利用了来自中国健康与退休长度调查 (CHARLS) 和中国城市统计年鉴的数据.
- 使用仪表变量 (IV) 方法来确定因果关系.
- 分析了对住院概率,频率,住院时间和相关费用的影响.
主要成果:
- 使用HCBS显著降低了住院率,住院频率,住院时间和所有测量的住院费用.
- 影响集中在年轻,男性,城市和高收入的残疾老年人中.
- 医疗保健和精神安慰服务显示出显著的负面影响;日常护理服务没有.
结论:
- HCBS有效地取代了医院护理,并控制了残疾老人的医疗费用.
- HCBS可以改善身体和心理健康,这表明除了降低成本之外还有更广泛的好处.
- 政策建议包括优先考虑HCBS,确保脆弱群体的可访问性,并优化服务开发.
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