Program on Aging, Long Term Care and Disability, Department of Health Policy and Management, School of Rural Public Health, Texas A&M Health Science Center (TAMU 1266), College Station, TX 77843, USA.
Health Serv Res. 2012 Aug;47(4):1642-59. doi: 10.1111/j.1475-6773.2012.01381.x. Epub 2012 Feb 21.
To test hypotheses concerning the relationship between formal and informal care and to estimate the impact of hours of formal care authorized for Medicaid Personal Care Services (PCS) on the utilization of informal care.
DATA SOURCES/STUDY SETTING: Data included home care use and adult Medicaid beneficiary characteristics from assessments of PCS need in four Medicaid administrative areas in Texas.
Cross-sectional design using ordinary least-squares (OLS) and instrumental variable (IV) methods.
DATA COLLECTION/EXTRACTION METHODS: The study database consisted of assessment data on 471 adults receiving Medicaid PCS from 2004 to 2006.
Both OLS and IV estimates of the impact of formal care on informal care indicated no statistically significant relationship. The impact of formal care authorized on informal care utilization was less important than the influence of beneficiary need and caregiver availability. Living with a potential informal caregiver dramatically increased the hours of informal care utilized by Medicaid PCS beneficiaries.
More formal home care hours were not associated with fewer informal home care hours. These results imply that policies that decrease the availability of formal home care for Medicaid PCS beneficiaries will not be offset by an increase in the provision of informal care and may result in unmet care needs.
检验关于正式照料和非正式照料之间关系的假设，并估计授权的医疗补助个人护理服务（PCS）正式照料时间对非正式照料利用的影响。
数据来源/研究环境：数据包括来自德克萨斯州四个医疗补助管理区域的 PCS 需求评估中的家庭护理使用情况和成年医疗补助受益人的特征。
使用普通最小二乘法（OLS）和工具变量（IV）方法的横截面设计。
数据收集/提取方法：本研究数据库由 2004 年至 2006 年期间接受医疗补助 PCS 的 471 名成年人的评估数据组成。
OLS 和 IV 对正式照料对非正式照料影响的估计都没有显示出统计学上的显著关系。正式照料授权对非正式照料利用的影响不如受益人的需求和照顾者的可用性的影响重要。与潜在的非正式照顾者同住极大地增加了医疗补助 PCS 受益人的非正式照顾时间。
更多的正式家庭护理时间与更少的非正式家庭护理时间无关。这些结果意味着，减少医疗补助 PCS 受益人的正式家庭护理供应的政策不会被非正式护理的增加所抵消，并且可能导致未满足的护理需求。
