Golberstein Ezra, Grabowski David C, Langa Kenneth M, Chernew Michael E
University of Michigan, Department of Health Management and Policy, USA.
Inquiry. 2009 Spring;46(1):58-71. doi: 10.5034/inquiryjrnl_46.01.58.
This paper assesses the effect of payment caps for Medicare home health care on the use of informal care by older adults with functional limitations. We find that individuals exposed to more restrictive payment caps offset reductions in Medicare home health care with increased informal care, although we only observe this effect for lower-income individuals. This suggests that home care payment restrictions may have increased the caregiving burden on some low-income families, but that many higher-income families were able to either forgo the care or finance it privately. Home care payment policies should recognize these effects, balancing costs of the program with the desire to protect families from the burdens associated with providing informal home care.
本文评估了医疗保险家庭医疗支付上限对功能受限老年人使用非正式护理的影响。我们发现，面临更严格支付上限的个人会通过增加非正式护理来抵消医疗保险家庭医疗服务的减少，尽管我们仅在低收入个人中观察到这种效应。这表明家庭护理支付限制可能增加了一些低收入家庭的护理负担，但许多高收入家庭能够放弃护理或自行承担费用。家庭护理支付政策应认识到这些影响，在项目成本与保护家庭免受提供非正式家庭护理相关负担的愿望之间取得平衡。
