Department of Pharmacy, The Comparative Health Outcomes, Policy and Economics (CHOICE) Institute, School of Pharmacy, University of Washington, Seattle, WA, USA.
Moss Adams, Portland, OR, USA.
J Am Med Dir Assoc. 2024 Jan;25(1):47-52. doi: 10.1016/j.jamda.2023.09.010. Epub 2023 Oct 17.
To examine long-term care out-of-pocket payments by dementia status and residential setting.
Compare monthly out-of-pocket long-term care expenses paid to facilities and helpers, total monthly out-of-pocket long-term expenses and as a percentage of monthly income by dementia status and residential status (community, residential facility, and nursing home).
US Nationwide, 2019 National Health and Aging Trends Study (NHATS) respondents aged ≥70 years.
We analyzed respondent-level data from the nationally representative 2019 NHATS. Weighted descriptive statistics were calculated for long-term care payments by source and summarized by dementia status and the respondent's residential status.
Among 4505 respondents aged ≥70 years, 1750 (38.8%) had possible or probable dementia and 2755 (61.2%) had no dementia. The median monthly out-of-pocket long-term care expenses for persons with dementia was $1465 for those living in nursing homes, and $2925 for those living in other residential facilities, much higher than those with dementia living in the community ($260). Although these are similar to the median out-of-pocket payments for persons without dementia by setting, those with dementia were at greater risk of facing catastrophic out-of-pocket expenses for long-term care than those without dementia, with the 75th percentile value of out-of-pocket payment at $4566 among dementia adults living in non-nursing home residential care facilities, and $7500 for those in nursing homes, compared to $3694 and $3100 among those without dementia. At median, these expenses accounted for 100% of monthly income of respondents with dementia living in facilities.
Persons with dementia living in facilities often face substantial financial burdens from high out-of-pocket long-term care expenses. Policies that provide sufficient financial assistance are needed to address long-term care-related financial burdens experienced by older adults and their families, especially for those with dementia.
检查痴呆症状况和居住环境对长期护理自付费用的影响。
按痴呆症状况和居住状况（社区、居住设施和养老院）比较设施和护工支付的每月长期护理自付费用、总每月长期护理自付费用以及占月收入的百分比。
全美，2019 年国家健康老龄化趋势研究（NHATS）年龄≥70 岁的受访者。
我们分析了全国代表性的 2019 年 NHATS 受访者的个人水平数据。按来源计算长期护理支付的加权描述性统计数据，并按痴呆症状况和受访者的居住状况进行总结。
在 4505 名年龄≥70 岁的受访者中，1750 名（38.8%）有或可能有痴呆症，2755 名（61.2%）没有痴呆症。居住在养老院的痴呆症患者每月自付长期护理费用中位数为 1465 美元，居住在其他居住设施的患者每月自付长期护理费用中位数为 2925 美元，远高于居住在社区的痴呆症患者（260 美元）。尽管这些费用与按居住环境划分的无痴呆症患者的中位数自付费用相似，但与无痴呆症患者相比，痴呆症患者面临长期护理自付费用灾难性支出的风险更大，居住在非养老院居住设施的痴呆症成年人中，自付费用的 75 分位值为 4566 美元，居住在养老院的自付费用为 7500 美元，而无痴呆症患者的自付费用分别为 3694 美元和 3100 美元。中位数而言，这些费用占居住在设施中的痴呆症患者月收入的 100%。
居住在设施中的痴呆症患者经常面临高额长期护理自付费用带来的巨大经济负担。需要制定足够的经济援助政策，以解决老年人及其家庭面临的长期护理相关经济负担，特别是对痴呆症患者。
