Toward a National Strategy for Long-Term Care of the Elderly A Study Plan (1986) / Chapter Skim
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Exhibit C: Overview of Existing Data Bases
Exhibit C: Overview of Existing Data Bases
Pages 95-146
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From page 95... ...
Munnell In order to devise an appropriate public response to the long-term care needs of the elderly, it is essential to assess the personal financial resources available to this group to cover the cost of this form of care. Such an assessment requires not only information on existing sources and levels of income and assets, but also projections of the financial status of the elderly in the future.
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From page 96... ...
While none of the existing surveys is ideal, the Current Population Survey, the New Beneficiary Survey and the Survey of Consumer Finances each provide important information for both purposes. Current Population Survey The most comprehensive and widely used source of information on the income situation of the elderly are the findings of the Census Bureau's Current Population Survey (CPS)
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From page 97... ...
SOURCE: Current Population Survey data, published in Susan Grad, Income of the Population 55 and Over, 1982 (Social Security Administration, 1984~.
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From page 98... ...
The NBS is a national, cross-sectional survey of retired and disabled workers who first began receiving social security benefits approximately one year before the survey date. Thus, the results of this survey provide detailed information about the economic status of the retired portion of the younger elderly population.
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From page 99... ...
TABLE 2 New Beneficiary Survey: Sources and Levels of Income for New Retirees, 1982 Percent Receiving Income Median Income Nonmarried Married Nonmarried Married Income Source Persons Coup1es Persons Couples Social Security 98% 97% $5,052 $7,752 Pensions 44 27 3~492 5,880 Earnings 56 42 4,704 7,404 Assets 84 69 1,188 2,160 SOURCE: Linda Drazga Maxfield and Virginia P Rena, "Distribution of Income Sources of Recent Retirees: Findings from the New Beneficiary Survey," Social Security Bulletin, vol.
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From page 100... ...
Canner, "Survey of Consumer Finances, 1983," Federal Reserve Bulletin vol. 70 (September 1984)
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From page 101... ...
Projections created by ICE Inc.'s PRISM model and the DYNASIM model of the Urban Institute provide the most complete and accurate estimates of retirement income sources and levels in the United States in the early 21st century.5 Ideally, each of these sources could be tapped to fill gaps in the other, thereby creating one comprehensive projection of retirement income to serve as a guideline for developing long-term care policies. However, several differences in the structure and components of the individual modules incorporated into the models and irreconcilable parameter differences used in the simulations prevent an easy integration (or even comparison)
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From page 102... ...
As discussed earlier, the Current Population Survey suffers from both undercoverage and nonreporting in the initial sample and underreporting of income in the final data base. Underreporting and nonreporting of income can cause serious obstacles to the accurate simulation of retirement income sources and levels.
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From page 103... ...
SOURCE: ICE, Inc., Future Retirement Benefits Under Employer Retirement Plans Final Report, prepared for the American Council of Life Insurance (June 1984)
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From page 104... ...
so~ ~ ~ ~ · v ~ ~ lo- ~ o ~ ~ o u - : On cn ~ ~ ~ o 1 lo lo o ~ o c., At ~ ~ o I ~ H · C)
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From page 105... ...
However, these techniques measure the likelihood that the observed data were indeed derived from the population in the model, and thus say nothing about the congruence of the model with the real world. In addition to these general problems, two deficiencies remain in microsimulation techniques that have a particular impact on their use for evaluating long-term care policies.
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From page 106... ...
Including income from home equity as a long-term care financing resource raises the percentages of married couples and single individuals who would be required to spend less than 10 percent of their income for long-term care insurance. The projections of future affordability of long-term care were based on the income estimates generated by a microsimulation of the PRISM model to the year 2015.
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From page 107... ...
SOURCE: ICE, Inc., Private Financing of Long Term Care: Current Methods and Resources, Phase 1, submitted to the Office of Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services (January 1985)
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From page 108... ...
This understates the percentage because the income levels used here do not include income from assets. Source: ICE, Inc., Private Financing of Lone Term Care: Current Methods am and Resources, Phase 1, submitted to the Office of Assistant Secretary for Planning and Evaluation, U.S.
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From page 109... ...
7. ICE, Inc., Private Financing of Long Term Care: Current Methods and Resources, Phases I and II, submitted to the Office of Assistant Secretary for Planning and Evaluation, U.S.
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From page 111... ...
In our previous study using existing long-term care data sets, we relied very heavily on the national data sets and used local area data sets when they involved representative samples of sufficient size to provide reliable estimates. There have been a number of inventories of long-term care data which indicate that more than 100 different data sets are available.
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From page 112... ...
The discussion is generic -- identifying generally what is available, not particular data sets. The national data sets will support reasonably reliable estimates of the size of the long-term care population and the types of needs of that population.
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From page 113... ...
The differences are of concern since the higher local estimates suggest a much larger population needing long-term care. What causes these differences is currently unknown and whether there reason to challenge the reliability of the national data remains an important issue.
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From page 114... ...
With regard to the local data sets, their primary value, as indicated earlier, is the capacity to study how various factors affect the use and costs of long-term caret By having data on the quantities of services consumed and their costs, and more details about the circumstances of the user and his environment, one can begin to examine behavior of users and caregivers. While permitting a much more detailed examination of use and costs than the national data, local area data are still significantly limited.
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From page 115... ...
Most other surveys of the elderly are random samples of the full elderly population, which means that the number of impaired is relatively small. The ASPE long-term care survey includes only persons who are impaired.
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From page 117... ...
Functionally Limited Elderly B) Chronic Mentally Ill C)
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From page 118... ...
Acronyms AARP ADAM ADD AJP ADA ASPE BLS CBO CDC CMHS CMI CSP DBE DD DEIS DHUD DOE DRG HCFA ~0 ICF-MR TOM LTC MR NAP NAS NCHS NCHSR NHANES NHIS NIA NIHR NIMH NINCDS NRC OASDI OMB OSEP OTA RWJ SSA SSDI SSI VA American Association of Retired Persons Alcohol, Drug Abuse & Mental Health Administration Administration on Developmental Disabilities American Journal of Psychiatry Administration on Aging Assistant Secretary for Planning & Evaluation Bureau of Health Manpower Congressional Budget Office Centers for Disease Control Community Mental Health Centers Chronic Mental Illness Community Support Program Division of Biometry & Epidemiology Developmentally Disabled Department of Health & Human Services Department of Housing & Urban Development Department of Education Diagnostic Related Groups Health Care Financing Administration Health Maintenance Organization Intensive Care Facilities for Mentally Retarded Institute of Medicine Long Term Care Mentally Retarded National Academy Press National Academy of Sciences National Center for Health Statistics National Center for Health Services Research National Health & Nutrition Examination Survey National Health Interview Survey National Institute on Aging National Institute for Handicapped Research National Institute on Mental Health National Institute of Neurological & Communicatial Disorders & Stroke National Research Council Old Age & Survivors, & Disability, Insurances Office of Management & Budget Office of Special Education Programs Office of Technology Assessment Robert Wood Johnson Foundation Social Security Administration Social Security Disability Insurance Supplemental Security Income Veterans Administration -118
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From page 119... ...
ADULT DISABLED: A Functionally Limited Elderly Major Primary Data Bases Existing/Cyclic - National Nursing Home Survey (1977)
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From page 120... ...
of New York - Study of Prospective Retirement Income - Urban Institute Report & Commissioned Papers of Cmte. on Nursing Home Regulation (1985)
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From page 121... ...
- DBE, NIMH - Study of Long-term care for chronically mentally ill - Urban Inst. - Young Adult Chronic Patients Analytical Review of Literature, Bachrach, Hosp.
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From page 122... ...
ADULT DISABI.F.n: C Physically Disabled Maior Primary Data Bases & Analytical Studies Existing/Cyclic - National Multiple Sclerosis Survey NINCDS National Head & Spinal Cord Injury Survey - NINCDS Survey of Disability & Work (1978)
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From page 123... ...
- NIHR MR population data base - Manpower Demonstration Research Corp. - NY Inventory of National Data Files on Handicapped Children & Youth (1985)
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From page 124... ...
of Ill. at Chicago Summary & analysis of recent national data on LTC of DD (MR)
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From page 125... ...
- NCHS Longitudinal Sample of Disability Insurance Applications; program statistics for SSI & SSDI - SSA Data tapes: Current Population Survey Series & Census tapes (1980) - Bureau of Census Panel Study of Income Dynamics (1984)
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From page 126... ...
Health Insurance Association of America -126New/Coming on Line - Demonstration: Hospital Initiatives in LTC (23 sites) - RWJ Foundation Study of LTC Financing & Organization - Brookings Study of Income Distribution Gaps Between Rich & Poor - American Council of Life Insurance LTC Insurance Report - ASPE - Medicaid Evaluation Project & Medicaid Expenditure Data - Urban Institute for HCFA - Strategies for Evaluation of Impact of DRG's on LTC - Urban Institute - Financing LTC Services, Federal program expenditures, needs for next decade, expenditure projections, alternative funding - CBO - Encouragement of Long-term-life cycle saving (5 Foci: reverse mortgage equity; family responsibility; private insurance for LTC; pensions & savings; labor & retirement laws)
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From page 127... ...
1984. Long-Term Care Financing and Delivery Systems: Exploring Some Alternatives.
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From page 128... ...
Long-Term Care Alternatives: Innovations in Financing Chronic Care for the Elderly.
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From page 129... ...
1984. Policy Forum: Private Insurance for Long Term Care -- Summary of Proceedings.
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From page 130... ...
1984. Long Term Care: The Challenge to Society Healthcare Financial Management Association.
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From page 131... ...
1984. The Future Growth of the Long Term Care Population: Projections Based on the 1977 National Nursing Home Survey and the 1982 Long Term Care Survey.
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From page 132... ...
1984. Long Term Care Provided within the Framework of Health Care Services (United States)
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From page 133... ...
Long-Term Care Alternatives: Innovations in Financing Chronic Care for the Elderly.
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From page 134... ...
1984. Long-Term Care Financing and Delivery Systems: Exploring Some Alternatives.
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From page 135... ...
1984. Changing Health Status and the Need for Institutional and Noninstitutional Long-Term Care Services.
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From page 136... ...
1981. Expanding Long Term Care Efforts: Options and Issues in State Program Design: A Synthesis of Findings from Research and Demonstration Projects.
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From page 137... ...
Vol I: Summary and Conclusions Vol II: The Long-Term Care Population: Definition and Measurement Vol III: Long-Term Care Service Utilization and Outcomes Vol IV: Financing Long-Term Care Vol V: Long-Term Care Service Supply: Levels and Behavior Vol VI: Long-Term Care Costs Appendix: Long-Term Care Instrument and Definition Review 58 Smits, Helen L., Judith Feder, and William Scanlon.
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From page 138... ...
ed.l983. Source Book on Long-Term Care Data.
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From page 139... ...
1984. Long-Term Care Cost Crisis: Can Private Insurance Bail Us Out?
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From page 140... ...
1984.~Reformihg Long Term Care: A Proposal for a Catastrophic, Managed Care Plan. Paper prepared for Institute of Medicine.
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From page 141... ...
1983. Oral Health Care in the Long Term Care Facility.
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From page 142... ...
Prepared for the national conference entitled Long-Term Care Financing and Delivery Systems: Exploring some Alternatives, sponsored by the Health Care Financing Administration, Washington, D.C.
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From page 143... ...
Long-Term Care Provided Within the Framework of Health Care Schemes.
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From page 144... ...
Urban Institute project report #3197-04. 150 Siebel, Robert V
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From page 145... ...
1984. The Future Growth of the Long Term Care Population: Projections Based on the 1977 National Nursing Home Survey and the 1982 Long Term Care Survey.
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From page 146... ...
1983. The Forgotten Costs of Informal Long-Term Care.
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