PDF(Pubmed)
Abstract：
The Medicaid Aging Waiver program (MAW) subsidizes the cost of long-term care (LTC) at home or in communities to satisfy older people\'s increasing desire to age in place. The MAW program might be health improving for older people by allowing them to age at home. However, less quality and quantity of home-based care comparing to nursing home care could offset some of the potential benefits. I use policy expenditure across states over time linked with detailed health information from the Health and Retirement Study (HRS) to identify the associated effects of MAWs on health outcomes of older adults who are at risk of needing LTC and who are resources constrained to be potentially eligible for Medicaid. Overall, the findings suggest that the MAW program is beneficial to health: a $1,000 increase in MAW spending for each older person results is associated with a 1.4 percent improvement in self-reported health status, a 1.5 percent reduction in functional mobility limitations, a 1.6 percent decrease in Instrumental Activities of Daily Living (IADL) limitations, and a 1.7 percent improvement in negative psychological feelings. For older people who are most likely not eligible for MAWs, such as those who are wealthy or in good health and do not require LTC, these health-improving effects have not been observed.
摘要：
医疗补助年龄豁免计划（MAW）补贴家庭或社区的长期护理（LTC）费用，以满足老年人日益增长的年龄需求。MAW计划可以通过允许老年人在家中变老来改善老年人的健康状况。然而,与疗养院护理相比，家庭护理的质量和数量较少，可能会抵消一些潜在的好处。随着时间的推移，我使用各州的政策支出与健康与退休研究（HRS）的详细健康信息相关联，以确定MAW对老年人健康结果的相关影响，这些老年人有需要LTC的风险，并且资源有限，可能有资格获得医疗补助。总的来说,研究结果表明，MAW计划对健康有益：每个老年人的MAW支出增加1,000美元，与自我报告的健康状况改善1.4％有关，功能移动性限制减少1.5%，日常生活工具活动(IADL)限制减少1.6%，负面心理情绪改善1.7%。对于最有可能没有资格获得MAW的老年人，例如那些富有或健康且不需要LTC的人，尚未观察到这些改善健康的作用。
