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老年人的自付医疗保健支出:照护安排重要吗?

Out-of-Pocket Health Care Spending at Older Ages: Do Caregiving Arrangements Matter?

作者信息

Friedman Esther M, Beach Scott R, Schulz Richard

机构信息

Institute for Social Research, 1259University of Michigan, Ann Arbor, MI, USA.

University Center for Social and Urban Research, 6614University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

J Appl Gerontol. 2023 May;42(5):1013-1021. doi: 10.1177/07334648231152401. Epub 2023 Jan 17.

Abstract

Identifying the correlates of out-of-pocket (OOP) health care spending is an important step for ensuring the financial security of older adults. Whether or not someone has a family member providing assistance is one such factor that could be associated with OOP spending. If family caregivers facilitate better health, health care spending could be reduced. On the other hand, costs would be higher if family members facilitate more (or more costly) care for loved ones. This paper explores the relationship between caregiving arrangements and OOP spending using data from 5045 individuals in the 2000-2016 Health and Retirement Study with Medicare coverage and caregiving needs. We do not find a relationship between family caregiving and OOP health care costs, overall. However, among those with Medicare HMO insurance, having a family caregiver is associated with more spending than having no helper. This is mainly due to differences in spending on prescription medications.

摘要

确定自付医疗保健支出的相关因素是确保老年人财务安全的重要一步。是否有家庭成员提供帮助就是一个可能与自付支出相关的因素。如果家庭护理人员能促进更好的健康状况,医疗保健支出可能会减少。另一方面,如果家庭成员为亲人提供更多(或更昂贵)的护理,成本就会更高。本文利用2000 - 2016年健康与退休研究中5045名有医疗保险覆盖和护理需求的个体数据,探讨了护理安排与自付支出之间的关系。总体而言,我们没有发现家庭护理与自付医疗保健成本之间存在关联。然而,在参加医疗保险健康维护组织(HMO)保险的人群中,有家庭护理人员的人与没有帮手的人相比,支出更多。这主要是由于处方药支出的差异。

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