@article {6921, title = {Out-of-pocket health care expenditures among older Americans with dementia.}, journal = {Alzheimer Dis Assoc Disord}, volume = {18}, year = {2004}, month = {2004 Apr-Jun}, pages = {90-8}, publisher = {18}, abstract = {

The number of older individuals with dementia will likely increase significantly in the next decades, but there is currently limited information regarding the out-of-pocket expenditures (OOPE) for medical care made by cognitively impaired individuals and their families. We used data from the 1993 and 1995 Asset and Health Dynamics Study, a nationally representative longitudinal survey of older Americans, to determine the OOPE for individuals with and without dementia. Dementia was identified in 1993 using a modified version of the Telephone Interview for Cognitive Status for self-respondents, and proxy assessment of memory and judgment for proxy respondents. In 1995, respondents reported OOPE over the prior 2 years for: 1) hospital and nursing home stays, 2) outpatient services, 3) home care, and 4) prescription medications. The adjusted mean annual OOPE was 1,350 US dollars for those without dementia, 2,150 US dollars for those with mild/moderate dementia, and 3,010 US dollars for those with severe dementia (p < 0.01). Expenditures for hospital/nursing home care (1,770 per year US dollars) and prescription medications (800 per year US dollars) were the largest OOPE components for those with severe dementia. We conclude that dementia is independently associated with significantly higher OOPE for medical care compared with those with normal cognitive function. Severe dementia is associated with a doubling of OOPE, mainly due to higher payments for long-term care. Given that the number of older Americans with dementia will likely increase significantly in the coming decades, changes in public funding aimed at reducing OOPE for both long-term care and prescription medications would have considerable impact on individuals with dementia and their families.

}, keywords = {Aged, Aged, 80 and over, Alzheimer disease, Costs and Cost Analysis, Data Interpretation, Statistical, Female, Financing, Personal, Health Care Costs, Health Expenditures, Health Surveys, Humans, Insurance Coverage, Longitudinal Studies, Male}, issn = {0893-0341}, doi = {10.1097/01.wad.0000126620.73791.3e}, author = {Kenneth M. Langa and Eric B Larson and Robert B Wallace and A. Mark Fendrick and Norman L Foster and Mohammed U Kabeto and David R Weir and Robert J. Willis and A. Regula Herzog} } @article {6536, title = {Overview of the Health Measures in the Health and Retirement Survey}, journal = {The Journal of Human Resources}, volume = {30}, year = {1995}, pages = {S84-S107}, publisher = {30}, abstract = {This report discusses the conceptual and logistical issues that lead to the items and instruments used to measure health and function status in Wave 1 of the Health and Retirement Study (HRS). Health status was conceptualized as multidimensional, and included selected major symptoms, diseases and conditions, global self-assessment of health, physical and cognitive functional status, the utilization of health services and selected elements of emotional health. In addition, two physiologic measures were obtained on a sample basis: grip strength and pulmonary maximum expiratory flow rate. Prevalence rates for major conditions and functional states are presented. Correlational analyses generally demonstrated a high rate of convergent, discriminant and construct validity. These findings should assist those intending to analyze HRS data in terms of the focus and utility of the measures employed.}, keywords = {Consumption and Savings, Health Conditions and Status, Healthcare, Methodology}, author = {Robert B Wallace and A. Regula Herzog} }