@article {7798, title = {Monetary costs of dementia in the United States.}, journal = {N Engl J Med}, volume = {368}, year = {2013}, month = {2013 Apr 04}, pages = {1326-34}, publisher = {386}, abstract = {

BACKGROUND: Dementia affects a large and growing number of older adults in the United States. The monetary costs attributable to dementia are likely to be similarly large and to continue to increase.

METHODS: In a subsample (856 persons) of the population in the Health and Retirement Study (HRS), a nationally representative longitudinal study of older adults, the diagnosis of dementia was determined with the use of a detailed in-home cognitive assessment that was 3 to 4 hours in duration and a review by an expert panel. We then imputed cognitive status to the full HRS sample (10,903 persons, 31,936 person-years) on the basis of measures of cognitive and functional status available for all HRS respondents, thereby identifying persons in the larger sample with a high probability of dementia. The market costs associated with care for persons with dementia were determined on the basis of self-reported out-of-pocket spending and the utilization of nursing home care; Medicare claims data were used to identify costs paid by Medicare. Hours of informal (unpaid) care were valued either as the cost of equivalent formal (paid) care or as the estimated wages forgone by informal caregivers.

RESULTS: The estimated prevalence of dementia among persons older than 70 years of age in the United States in 2010 was 14.7\%. The yearly monetary cost per person that was attributable to dementia was either $56,290 (95\% confidence interval [CI], $42,746 to $69,834) or $41,689 (95\% CI, $31,017 to $52,362), depending on the method used to value informal care. These individual costs suggest that the total monetary cost of dementia in 2010 was between $157 billion and $215 billion. Medicare paid approximately $11 billion of this cost.

CONCLUSIONS: Dementia represents a substantial financial burden on society, one that is similar to the financial burden of heart disease and cancer. (Funded by the National Institute on Aging.).

}, keywords = {Aged, Aged, 80 and over, Cost of Illness, Dementia, Female, Health Care Costs, Home Care Services, Home Nursing, Humans, Longitudinal Studies, Male, Medicare, Middle Aged, Nursing homes, United States}, issn = {1533-4406}, doi = {10.1056/NEJMsa1204629}, url = {http://www.nejm.org/doi/full/10.1056/NEJMsa1204629}, author = {Michael D Hurd and Martorell, Paco and Delavande, Adeline and Kathleen J Mullen and Kenneth M. Langa} } @article {7401, title = {Methodological Innovations in Collecting Spending Data: The HRS Consumption and Activities Mail Survey.}, journal = {Fisc Stud}, volume = {30}, year = {2009}, note = {Journal Article}, month = {2009 Dec 01}, pages = {435-459}, publisher = {30}, abstract = {

It has traditionally been believed that collecting survey measures of total spending necessarily involved asking a large number of questions, too many for inclusion of a comprehensive spending measure in a general-purpose survey. In this paper we report on a supplemental survey to the Health and Retirement Study that took up this challenge. We discuss issues that arise designing a survey module to collect spending data with strict time constraints, describe how the implementation in the Consumption and Activities Mail Survey (CAMS) played out, and elicit anomalies that more detailed analysis of data quality revealed. We report how we addressed some of these anomalies in subsequent waves of CAMS. Other anomalies required conducting additional randomized experiments to find what explains the observed patterns. The results highlight the tension between asking about spending using a long time frame, which exacerbates recall bias, versus using a short time frame, which risks relying on an unrepresentative snapshot of a household{\textquoteright}s spending to proxy the total for the last 12 months. An important complicating factor in deciding which goods should be put into which time frames is that there is substantial heterogeneity in the frequency of spending across households even for the same category of spending.

}, issn = {0143-5671}, doi = {10.1111/j.1475-5890.2009.00103.x}, url = {URL:http://www.wiley.com/bw/journal.asp?ref=0143-5671 Publisher{\textquoteright}s URL}, author = {Michael D Hurd and Susann Rohwedder} } @article {6588, title = {Medical insurance and the use of health care services by the elderly.}, journal = {J Health Econ}, volume = {16}, year = {1997}, month = {1997 Apr}, pages = {129-54}, publisher = {16}, abstract = {

The objective of this paper is to find how health insurance influences the use of health care services by the elderly. On the basis of the first wave of the Asset and Health Dynamics Survey, we find that those who are the most heavily insured use the most health care services. Because our data show little relationship between observable health measures and either the propensity to hold or to purchase private insurance, we interpret this as an effect of the incentives embodied in the insurance, rather than as the result of adverse selection in the purchase of insurance.

}, keywords = {Activities of Daily Living, Aged, Health Care Surveys, Health Services for the Aged, Health Status Indicators, Hospitalization, Humans, Insurance, Health, Medicare, Office Visits, Patient Acceptance of Health Care, Private Sector, Probability, United States}, issn = {0167-6296}, doi = {10.1016/s0167-6296(96)00515-2}, url = {https://www.ncbi.nlm.nih.gov/pubmed/10169091}, author = {Michael D Hurd and Kathleen McGarry} }