Lopez Casasnovas Guillem, Nicodemo Catia
Universitat Pompeu Fabra, CRES and BGSE, Spain.
University of Oxford, CHSEO, Department of Economics, Manor Road, OX 1 3UQ Oxford, UK.
Disabil Health J. 2016 Jan;9(1):26-36. doi: 10.1016/j.dhjo.2015.07.006. Epub 2015 Aug 28.
In recent decades demographic changes (low fertility rates, increased life expectancy…) in most OECD countries, have brought profound changes in the population pyramid, with several effects in the welfare of society. One of them is the increase in the number of people with disabilities, since age is a determining factor in the emergence of this dependency.
OBJECTIVE/HYPOTHESIS: This paper studies the probability to enter and transit in and from a disability state, as well as its associated mortality, by attending to the distinction between the initial disability level and the process that leads on from it, and by addressing whether and how education, age and income affect this transition.
Applying a Markov model and a survival analysis to new Spanish administrative data set (Muestra Continua de Vida Laboral (MCVL)) we estimate the probability that a person changes the state of disability and the duration of her progression in each case.
We find that people with an initial state of disability have a higher propensity to change status and take less time to transit amongst different stages than those who have no disability. Men do so more frequently than women and income have negative effects on the transition.
These results may help to incorporate into welfare programs some protection mechanisms for delaying transitions and target the most fragile population groups.
近几十年来，大多数经合组织国家的人口结构变化（低生育率、预期寿命增加……）给人口金字塔带来了深刻变化，对社会福利产生了多方面影响。其中之一是残疾人数的增加，因为年龄是导致这种依赖性出现的一个决定性因素。
目的/假设：本文通过关注初始残疾水平与其后续发展过程之间的区别，并探讨教育、年龄和收入是否以及如何影响这种转变，研究进入残疾状态、在残疾状态中转变以及脱离残疾状态的概率，及其相关死亡率。
应用马尔可夫模型和生存分析方法，对新的西班牙行政数据集（劳动力连续生命样本（MCVL））进行分析，我们估计了一个人改变残疾状态的概率以及每种情况下其病情进展的持续时间。
我们发现，初始处于残疾状态的人比无残疾的人更倾向于改变状态，且在不同阶段转变所需时间更短。男性比女性更频繁地改变状态，收入对这种转变有负面影响。
这些结果可能有助于在福利项目中纳入一些延缓转变的保护机制，并针对最脆弱的人群。
