State expenditures on home and community based services and use of formal and informal personal assistance: a multilevel analysis.

TitleState expenditures on home and community based services and use of formal and informal personal assistance: a multilevel analysis.
Publication TypeJournal Article
Year of Publication2002
AuthorsMuramatsu, N, Campbell, RT
JournalJ Health Soc Behav
Volume43
Issue1
Pagination107-24
Date Published2002 Mar
ISSN Number0022-1465
Call Numberpubs_2002_Muramatsu.pdf
KeywordsAged, Aged, 80 and over, Community Health Services, Female, Financing, Government, Frail Elderly, Health Care Surveys, Health Expenditures, Home Care Services, Humans, Logistic Models, Male, State Government
Abstract

Despite wide state variation in commitment to home and community-based services (HCBS) for functionally impaired older persons, little is known about how such variation affects older adults' strategies to compensate for their functional limitations. This study examines the association of state HCBS expenditures with use of formal and informal personal assistance among non-institutionalized older Americans aged 70 and older with functional limitations. We conducted multilevel multinomial logistic regression analysis using data from the first wave of the Assets and Health Dynamics among the Oldest Old Survey, combined with data on state HCBS expenditures. Controlling for individuals' demographic, socioeconomic, and care needs factors, persons residing in states with higher HCBS expenditures were more likely to use formal personal assistance, but not less likely to use informal assistance. Our study suggests state variation in HCBS expenditures leads to inequitable access to formal personal assistance, especially among those with high functional limitations.

Notes

RDA 1996-025

URLhttps://www.ncbi.nlm.nih.gov/pubmed/11949194
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/11949194?dopt=Abstract

Endnote Keywords

Aged, 80 and Over/Community Health Services/Female/Financing, Government/Statistics and Numerical Data/Frail Elderly/Health Care Surveys/Health Expenditures/Home Care Services/Logistic Models/State Government/Support, U.S. Government--PHS

Endnote ID

4120

Alternate JournalJ Health Soc Behav
Citation Key6792
PubMed ID11949194
Grant ListAG16007-01 / AG / NIA NIH HHS / United States