Strokes and hip fractures are major causes of long-term disability, institutionalization and mortality among elderly persons. These health conditions generate significant acute, post-acute, and long-term care (LTC) costs for Medicare, state Medicaid programs, and for the affected individuals and families. This application is a four year continuation study which builds on the investigators' current research examining the effects of public subsidies on families' long-term care decisions. They propose to evaluate the costs of these diseases and the cost-effectiveness/benefit of various interventions and public subsidies by collecting data from hospital charts for 1,162 National Long-Term Care Survey respondents who experienced a stroke or hip fracture between 1987 and 1994 to supplement data from prior NLTCS interviews and Medicare service data. The analyses will examine: 1) long-term effects of Medicare-subsidized rehabilitation services on mortality, health, functional, and cognitive status of stroke and hip-fracture patients; 2) assess the determinants of the amount of Medicare-subsidized services stroke/hip fracture patients receive following hospitalization; 3) determine social value of rehabilitative services relative to their costs; and 4) examine the effects of public subsidies of supportive care on living arrangements, and use of formal and informal care received by these patients. The models and strategies developed for stroke and hip fracture may be applicable for other types of diseases affecting the elderly.

National Institute of Health (NIH)
National Institute on Aging (NIA)
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Social Sciences and Population Study Section (SSP)
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Duke University
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Picone, Gabriel; Mark Wilson, R; Chou, Shin-Yi (2003) Analysis of hospital length of stay and discharge destination using hazard functions with unmeasured heterogeneity. Health Econ 12:1021-34
Chou, Shin-Yi (2002) Asymmetric information, ownership and quality of care: an empirical analysis of nursing homes. J Health Econ 21:293-311
Picone, Gabriel; Chou, Shin-yi; Sloan, Frank (2002) Are for-profit hospital conversions harmful to patients and to Medicare? Rand J Econ 33:507-23
Sloan, Frank A; Taylor Jr, Donald H (2002) Effect of Alzheimer disease on the cost of treating other diseases. Alzheimer Dis Assoc Disord 16:137-43
Sloan, F A; Picone, G A; Taylor, D H et al. (2001) Hospital ownership and cost and quality of care: is there a dime's worth of difference? J Health Econ 20:1-21
Counts, S E; Perez, S E; Kahl, U et al. (2001) Galanin: neurobiologic mechanisms and therapeutic potential for Alzheimer's disease. CNS Drug Rev 7:445-70
Sloan, F A; Taylor Jr, D H; Picone, G (1999) Costs and outcomes of hip fracture and stroke, 1984 to 1994. Am J Public Health 89:935-7
Taylor Jr, D H; Whellan, D J; Sloan, F A (1999) Effects of admission to a teaching hospital on the cost and quality of care for Medicare beneficiaries. N Engl J Med 340:293-9