Short P F, Kemper P
Center for Intramural Research, Agency for Health Care Policy and Research, Rockville, MD 20852.
Inquiry. 1994 Summer;31(2):141-52.
There are a number of proposals to expand substantially public financing of nursing home care. Included among the major elements of these proposals are front-end benefits limited to three or six months, back-end benefits with waiting periods of one or two years, and coverage of all nursing home days with or without substantial income-related cost sharing. Using data from the 1987 National Medical Expenditure Survey, this paper simulates the effect of these proposed changes in nursing home financing on public expenditures, Medicaid expenditures, and private expenditures (in total and by marital status and income group). The incentive for increased use of nursing home care also is examined. A short front-end benefit, the least expensive option in terms of public expenditures, increases public expenditures by $1 billion to $2 billion in 1987. Comprehensive coverage of all nursing home days increases public costs by $9 billion to $10 billion dollars, depending on the cost-sharing arrangement. There is wide variation in the range of plausible estimates because of uncertainty about the effect of increased public coverage of nursing home care on utilization.
有多项大幅扩大疗养院护理公共资金投入的提议。这些提议的主要内容包括前端福利（限于三到六个月）、后端福利（等待期为一到两年）以及无论是否有与收入相关的高额费用分摊，均涵盖所有疗养院护理天数。本文利用1987年全国医疗支出调查的数据，模拟了这些提议的疗养院融资变化对公共支出、医疗补助支出和私人支出（总体以及按婚姻状况和收入群体划分）的影响。还研究了增加使用疗养院护理的激励因素。前端福利期限较短，从公共支出角度来看是成本最低的选项，在1987年使公共支出增加了10亿美元到20亿美元。根据费用分摊安排，全面覆盖所有疗养院护理天数会使公共成本增加90亿美元到100亿美元。由于疗养院护理公共覆盖范围扩大对利用率的影响存在不确定性，合理估计范围存在很大差异。
