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Biomedical subjects

L Corder

Publications and source records attributed to L Corder.

11 recordsLinked to original sources
PubMed1999

A Danish population-based twin study on general health in the elderly.

OBJECTIVES: To study the relative influence of genetic and environmental factors on self-rated health and hospitalization patterns in the elderly. METHODS: A survey among all 3,099 Danish twins ages 75 years and older identified in the Danish Twin Registry. An interview was conducted with 77% of the twins. The number of hospitalizations in the previous 18 years was obtained through register linkage, thereby obtaining health information on 96% of the study population, including all nonresponders. RESULTS: Structural equation modeling suggested that approximately a quarter of the variation in the liability to self-reported health and the number of hospitalizations could be attributed to genetic factors. The remaining variation was most likely due to nonfamilial environment. Analyses of the hospitalization patterns of proxy responders and nonresponders suggest that the estimates of the genetic influence on health outcomes in the study are conservative. DISCUSSION: The present study indicates that variation in general health among the elderly is partly explained by genetic factors.

Aged↗
PubMed1997

Chronic disability trends in elderly United States populations: 1982-1994.

Statistically significant declines in chronic disability prevalence rates were observed in the elderly United States population between the 1982 and 1989 National Long Term Care Surveys (NLTCS). The 1994 NLTCS was used to investigate whether disability rate declines continued to 1994. The 1982, 1984, 1989, and 1994 NLTCS employ the same sample design and instrumentation so that trends in disability can be estimated with minimal sampling and measurement bias. Age (5-year categories from 65 to >95)-specific rates were calculated for the 1982 NLTCS and applied to United States Census Bureau estimates of the 1994 population to calculate chronic disability prevalence rates adjusted for aging in the United States population aged > 65. The 1982 age standardized rates were compared with 1994 NLTCS estimates. The prevalence of disability estimated for 1994 (21.3%) was 3.6% lower than the 1982 age standardized rate (24.9%)-a highly significant reduction (t = -8.5; P << 0.0001). Of the 3.6 percentage point decline in prevalence, 1.7% occurred in the 5 years between 1989 and 1994-compared with the 1.9% decline in the 7 years between 1982 and 1989. Both declines are significant. Because of the shorter time period, the per year decline in disability prevalence from 1989 to 1994 was greater than that from 1982 to 1989. Given the higher acute and long-term care service needs of the disabled elderly population, Medicare, Medicaid, and private health expenditures may be dramatically lower than if declines had not occurred.

Activities of Daily Living↗
PubMed1997

Cost of illness due to dementia in Sweden.

The gross cost of illness due to dementia was estimated to be SEK30.7 billion in 1991 while the net cost was estimated to be SEK20 billion. The sensitivity analysis showed a variation between SEK20 billion and SEK36 billion in 1991.

Aged↗
PubMed1997

Education-specific estimates of life expectancy and age-specific disability in the U.S. elderly population: 1982 to 1991.

The authors used mortality data for 1982 to 1991 linked to survey records from the 1982, 1984, and 1989 National Long Term Care Surveys to calculate gender differences over age in mortality and functional status for high (8 or more years of schooling) and low (less than 8 years of schooling) education subgroups. Males and females with high education maintained better functioning at later ages than those with low education. The authors also found that mortality was higher, after conditioning on disability, in both the male and female low-education than the male and female high-education groups. The size of the education effect on both disability and mortality was large, for example, about 7.6 years difference in female life expectancy at age 65; a roughly 2-year difference for males.

Activities of Daily Living↗
PubMed1997

Changes in the age dependence of mortality and disability: cohort and other determinants.

Though the general trend in the United States has been toward increasing life expectancy both at birth and at age 65, the temporal rate of change in life expectancy since 1900 has been variable and often restricted to specific population groups. There have been periods during which the age- and gender-specific risks of particular causes of death have either increased or decreased. These periods partly reflect the persistent effects of population health factors on specific birth cohorts. It is important to understand the ebbs and flows of cause-specific mortality rates because general life expectancy trends are the product of interactions of multiple dynamic period and cohort factors. Consequently, we first review factors potentially affecting cohort health back to 1880 and explore how that history might affect the current and future cohort mortality risks of major chronic diseases. We then examine how those factors affect the age-specific linkage of disability and mortality in three sets of birth cohorts assessed using the 1982, 1984, and 1989 National Long Term Care Surveys and Medicare mortality data collected from 1982 to 1991. We find large changes in both mortality and disability in those cohorts, providing insights into what changes might have occurred and into what future changes might be expected.

Activities of Daily Living↗
PubMed1995

Changes in morbidity and chronic disability in the U.S. elderly population: evidence from the 1982, 1984, and 1989 National Long Term Care Surveys.

We examined changes in the reported prevalence of 16 medical conditions in the U.S. population age 65 and above using data from the 1982, 1984, and 1989 National Long Term Care Surveys. Changes in those disease prevalence rates were examined both as observed, and after standardizing for changes in the age, sex, and disability distributions in the U.S. elderly population between 1982 and 1989. We found significant declines in the net prevalence of the 16 medical conditions between 1982 and 1989. Significant changes were found in different disability, age, and gender groups and after standardizing for declines in disability in addition to age and sex. The declines in morbidity reported between 1982 and 1989 are consistent with the declines reported in the 1982 and 1989 National Long Term Care Surveys in the age and sex standardized prevalence of chronic disability and institutionalization.

Age Distribution↗
PubMed1993

Changes in the use of personal assistance and special equipment from 1982 to 1989: results from the 1982 and 1989 NLTCS.

Analysis of data from the 1982, 1984 and 1989 National Long-term Care Surveys suggests that long-term care use is changing. Between 1982 and 1989, equipment use by persons with light physical impairment, or to supplement personal assistance for the severely disabled, increased. Over this same period, there was a decline in the use of personal assistance as the sole modality to deal with chronic impairments. Since equipment costs are nonrecurrent, whereas personal assistance costs are recurrent, this finding has implications for long-term care policy.

Activities of Daily Living↗
PubMed1986

First 6 months of Medicaid data.

This is the first in a series of comprehensive Medicaid program reports based on National Medical Care Utilization and Expenditure Survey (NMCUES) data. Preliminary analyses are presented based on data from the first half of 1980, which include the personal characteristics and medical care utilization patterns of noninstitutional Medicaid enrollees and the health insurance coverage of the U.S. noninstitutionalized population. More comprehensive analyses employing full calendar year 1980 data will be available in subsequent reports. The information contained in this report is useful in appraising the impact of eligibility, benefit package, and reimbursement policy on Medicaid enrollee health care utilization at both the Federal and the State Medicaid level. Despite the expectations of the Medicaid program's architects that it would be smaller and less significant than the Medicare program, the Medicaid program has experienced dramatic growth in the number of recipients and total expenditures since its creation. By early 1980, State Medicaid program expenditures accounted for between 10 and 15 percent of individual State general operating funds. The Medicaid program is continuing to grow relative to State budgets. State budgets have been expanding by only about 9 percent per year, while Medicaid budget expenditures have been expanding at approximately twice that rate. These factors are forcing States to devise program changes concerning eligibility, benefits, or reimbursement approaches that will enable them to maintain fiscal stability as expenditures increase and the Federal role changes. These problems present a major challenge to policymakers and administrators at both the Federal and State levels. Solutions to these problems are difficult because of the differences in Medicaid programs, the constantly changing character of the Medicaid programs within States, and a lack of data to describe, monitor, and forecast Medicaid program activities in a consistent fashion. NMCUES was designed with these data problems in mind. Survey Background The goal of the National Medical Care Utilization and Expenditure Survey (NMCUES) is to collect information that will improve our understanding of the way Americans use and pay for health care. In addition to providing reliable statistical descriptions of the types of health services consumed and the amount of dollars expended for health care by the Nation, NMCUES was designed to permit health policy analysts to investigate a broad range of issues concerning the financing and delivery of health services in the United States. NMCUES data reflect health care experiences of the civilian noninstitutionalized population during 1980.(ABSTRACT TRUNCATED AT 400 WORDS)

Ambulatory Care↗
PubMed1985

Out-of-pocket health expenses for Medicaid and other poor and near-poor persons in 1980.

The Medicaid program (Title XIX of the Social Security Act) was designed to provide access to health services at little or no out-of-pocket expense to low-income persons who might otherwise not be able to afford them. Information was collected through household interviews in the National Medical Care Utilization and Expenditure Survey (NMCUES) on total out-of-pocket expenditures for health care by noninstitutionalized persons in the United States in 1980. This report presents data to assess the degree to which Medicaid enrollees incur out-of-pocket expenses. These levels of expenditures are compared to those experienced by other persons not eligible for Medicaid who are below or near the official poverty level. Data contained in this report were derived from the National Household Survey (HHS), a panel survey of 6,600 households representative of the civilian, noninstitutionalized U.S. population, which is only one of the three surveys that were conducted as part of NMCUES. The other two surveys are a State Medicaid Household Survey (SMHS) of Medicaid households in four States and the Administrative Records Survey (ARS), a survey of existing Medicare and Medicaid administrative records for sample households. Since data were derived only from HHS, the findings in this report are national (or regional) in scope and cannot be tied directly to differences in individual State Medicaid programs. The data on eligibility and expenditures are all self-reported and have not been verified by administrative records. One definite limitation of these data is the exclusion from the NMCUES sample of all institutionalized persons. As a result, out-of-pocket expenses for one particularly high-cost group are excluded, and total out-of-pocket expenditures for each health insurance coverage group are understated. Another potential limitation of this analysis is that, as with many surveys, limited data on key items (such as out-of-pocket expenses and income) were at times missing from respondent reports. These missing data were imputed according to standard statistical techniques (see Appendix III). A variety of findings is presented, including data on the effect of health insurance coverage, demographic characteristics, health status, and continuity of Medicaid enrollment on out-of-pocket expenses. Within insurance coverage categories, Medicaid-covered persons had the lowest out-of-pocket expenses. This was true even though they had the highest mean per capita charges for care. Among the demographic characteristics that were analyzed, age and race had the most impact on the level of out-of-pocket health expenses.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1983

Six months of Medicaid data: a summary from the National Medical Care Utilization and Expenditure Survey.

This is a summary of the first report in a series of three comprehensive Medicaid program reports based on National Medical Care Utilization and Expenditure Survey data. Preliminary analyses are presented based on data from the first half of 1980 which include the personal characteristics and medical care utilization patterns of noninstitutional Medicaid enrollees and the health insurance coverage of the U.S. noninstitutionalized population. More comprehensive analyses employing full calendar year 1980 data will be available in subsequent reports. The information provided in this summary is useful in appraising the impact of eligibility, benefit package, and reimbursement policy on Medicaid enrollee health care utilization at both the Federal and the State Medicaid level.

Data Collection↗