Dataset Information

Effects of long-term care setting on spousal health outcomes.

ABSTRACT:

Objective

To provide empirical evidence on the effects of home and community-based services (HCBS) (vs nursing home) use on spousal health.

Data sources

Merged data from the 1996 to 2012 Health and Retirement Study (HRS) and the Area Health Resource File (AHRF).

Study design

We assess the impact of HCBS use on spousal health. We use an instrumental variable (IV) approach to account for the potential endogeneity of the choice of care setting and reverse causality. Our instrument is the supply of skilled nursing home beds per 1000 people older than 65 years.

Data extraction methods

Our sample includes spouses of HCBS or nursing home users, resulting in 8608 observations.

Principal findings

We find that HCBS use leads to harmful effects on spousal physical health, which may be caused by increased informal care responsibilities. We also find improved spousal mental health, especially in depression symptoms, which may be caused by increased satisfaction.

Conclusions

We find evidence of both beneficial (mental health) and harmful (physical health) consequences for spouses of individuals receiving LTC at home relative to in an institution. Our results are important in estimating the potential cost and effectiveness of HCBS expansion.

SUBMITTER: Dong J

PROVIDER: S-EPMC6338294 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effects of long-term care setting on spousal health outcomes.

Dong Jing J Pollack Harold H Konetzka Rita Tamara RT

Health services research 20180923 1

<h4>Objective</h4>To provide empirical evidence on the effects of home and community-based services (HCBS) (vs nursing home) use on spousal health.<h4>Data sources</h4>Merged data from the 1996 to 2012 Health and Retirement Study (HRS) and the Area Health Resource File (AHRF).<h4>Study design</h4>We assess the impact of HCBS use on spousal health. We use an instrumental variable (IV) approach to account for the potential endogeneity of the choice of care setting and reverse causality. Our instru ...[more]

PMID: 30246337

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Project description:BackgroundIn 2015, it was estimated that the burden of disease in Iran comprised of 19 million disability-adjusted life years (DALYs), 74% of which were due to non-communicable diseases (NCDs). The observed leading causes of death were cardiovascular diseases (41.9%), neoplasms (14.9%), and road traffic injuries (7.4%). Even so, the health research investment in Iran continues to remain limited. This study aims to identify national health research priorities in Iran for the next five years to assist the efficient use of resources towards achieving the long-term health targets.MethodsAdapting the Child Health and Nutrition Research Initiative (CHNRI) method, this study engaged 48 prominent Iranian academic leaders in the areas related to Iran's long-term health targets, a group of research funders and policy makers, and 68 stakeholders from the wider society. 128 proposed research questions were scored independently using a set of five criteria: feasibility, impact on health, impact on economy, capacity building, and equity.FindingsThe top-10 priorities were focused on the research questions relating to: health insurance system reforms to improve equity; integration of NCDs prevention strategy into primary health care; cost-effective population-level interventions for NCDs and road traffic injury prevention; tailoring medical qualifications; epidemiological assessment of NCDs by geographic areas; equality in the distribution of health resources and services; current and future common health problems in Iran's elderly and strategies to reduce their economic burden; the status of antibiotic resistance in Iran and strategies to promote rational use of antibiotics; the health impacts of water crisis; and research to replace the physician-centered health system with a team-based one.ConclusionsThese findings highlight consensus amongst various prominent Iranian researchers and stakeholders over the research priorities that require investment to generate information and knowledge relevant to the national health targets and policies. The exercise should assist in addressing the knowledge gaps to support both the National General Health Policies by 2025 and the health targets of the United Nations' Sustainable Development Goals by 2030.

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Dataset Information

Effects of long-term care setting on spousal health outcomes.

Objective

Data sources

Study design

Data extraction methods

Principal findings

Conclusions

Publications

Effects of long-term care setting on spousal health outcomes.

Similar Datasets

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