Spillman B C, Kemper P
Center for Intramural Research, Agency for Health Care Policy and Research, Rockville, MD 20852.
Home Health Care Serv Q. 1992;13(1-2):5-34.
When private resources are defined broadly to include informal care as well as private expenditures, 73 percent of the elderly long term care population rely entirely on private resources for their care. The emphasis of current programs on institutional care directs public resources toward those with more serious disability and less family to care for them. Among those with four or five disabilities in ADLS, 35 percent of those without a spouse or children currently receive no public support, compared with nearly 80 percent of those with both a spouse and children. Thus, even if restricted to seriously disabled persons, a new program expanding public long term care financing would increase eligibility for public benefits disproportionately among those with greater informal care resources.
当私人资源被宽泛定义为包括非正式照料以及私人支出时，73%的老年长期护理人群完全依靠私人资源来获得照料。当前项目对机构照料的重视将公共资源导向了那些残疾程度更严重且照料他们的家人较少的人群。在日常生活活动能力有四项或五项残疾的人群中，目前没有配偶或子女的人中有35%未得到任何公共支持，相比之下，有配偶和子女的人这一比例接近80%。因此，即便仅限于严重残疾者，一项扩大公共长期护理资金的新项目也会使那些拥有更多非正式照料资源的人群获得公共福利资格的比例出现不成比例的增加。
