引入长期服务和支持的管理护理中介机构的影响
Deepon Bhaumik1, Jacob Wallace2, David C Grabowski1
1Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
Health services research
|February 27, 2025
概括
长期管理服务和支持 (MLTSS) 增加了家庭护理的使用,但减少了受益人获得的正式护理时间. 这些计划扩大了对家庭和社区服务 (HCBS) 的获取.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 老年学是一门学科.
- 公共卫生政策 公共卫生政策
背景情况:
- 长期管理服务和支持 (MLTSS) 计划旨在协调对有功能限制的个人的护理.
- 了解MLTSS对服务利用和健康结果的影响对于优化老年护理至关重要.
- 之前的研究还没有完全阐明MLTSS对正式和非正式护理使用以及急性护理利用的影响.
研究的目的:
- 评估MLTSS实施对长期护理和急症护理服务利用的影响.
- 分析MLTSS推出后的正式家庭护理,非正式护理,养老院使用和住院治疗的变化.
- 评估MLTSS对受益人获得的正式护理数量的影响.
主要方法:
- 使用一个分阶差异回归设计 (DiDs).
- 分析了来自健康和退休研究 (HRS) 的二次数据,与州标识符相关联.
- 包括65岁以上至少有一种功能限制的成年人,比较2004-2018年MLTSS和没有MLTSS的状态.
主要成果:
- 实施MLTSS与家庭护理用户增加2.5个百分点有关.
- 观察到非正式护理用户的比例下降了3个百分点.
- 没有发现养老院占用率或健康结果的显著变化;然而,在家庭护理接受者身上,每月正式护理时间 (7.02小时) 显著减少.
结论:
- MLTSS计划扩大了个人使用家庭和社区服务 (HCBS) 的比例.
- 每个受益人使用的HCBS数量在MLTSS下下降.
- 需要进一步调查,以确定这些变化是否以牺牲受益人的幸福为代价.
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