Waidmann T A, Liu K
The Urban Institute, Washington, DC 20037, USA.
J Gerontol B Psychol Sci Soc Sci. 2000 Sep;55(5):S298-307. doi: 10.1093/geronb/55.5.s298.
This article used a new data source to examine the issue of disability trends among elderly persons and examined the potential implications of these trends on future health and long-term care needs.
We used the 1992-1996 Medicare Current Beneficiary Survey to examine time trends in rates of activities of daily living and instrumental activities of daily living disability and physical limitation among Medicare beneficiaries aged 65 and over. We used multinomial logit and least squares regression techniques to produce trend estimates that held the age, sex, race, and educational distributions constant and projected these trends into the future. Finally, we estimated the potential impact of disability decline on per capita Medicare spending on elderly persons.
We found that disability among elderly persons is declining and that the trend toward a more educated elderly cohort explains some, but not all, of this decline. In the absence of downward disability trends, per capita Medicare expenditures would have grown even faster than they have.
Although the decline in disability prevalence in recent years appears real, whether it continues has enormous implications for the size of the disabled population in the future and for the ability of the society to care for its disabled elderly members.
本文使用了一种新的数据源来研究老年人残疾趋势问题，并探讨这些趋势对未来健康和长期护理需求的潜在影响。
我们利用1992 - 1996年医疗保险当前受益人调查，研究65岁及以上医疗保险受益人的日常生活活动、工具性日常生活活动残疾率和身体限制的时间趋势。我们使用多项逻辑回归和最小二乘回归技术来生成趋势估计值，使年龄、性别、种族和教育分布保持不变，并将这些趋势预测到未来。最后，我们估计了残疾率下降对老年人人均医疗保险支出的潜在影响。
我们发现老年人的残疾率正在下降，老年人群体受教育程度提高的趋势解释了这种下降的部分而非全部原因。如果没有残疾率下降的趋势，人均医疗保险支出的增长速度会比实际更快。
尽管近年来残疾患病率的下降似乎是真实的，但它是否会持续对未来残疾人口规模以及社会照顾其残疾老年成员的能力具有重大影响。
