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Longitudinal Care Patterns For Disabled Elders: A Bayesian Analysis of Missing Data

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Case Studies in Bayesian Statistics, Volume II

Part of the book series: Lecture Notes in Statistics ((LNS,volume 105))

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Abstract

The growth in the number of dependent elderly and the concurrent decline in the availability of informal caregivers has led to increasing concern that use of publicly-funded long-term care services will rise, as community-residing elders substitute these formal services for informal care. To investigate the extent of service substitution and identify correlates, longitudinal data from a study of elders and their informal caregivers were analyzed. Over 50% of subjects were missing the outcome of interest, although only 8% had no partial outcome data. This paper compares results from three missing-data methods: complete-case analysis, single regression imputation, and multiple regression imputation. Prior assumptions regarding the distribution of the outcome among nonrespondents were varied in order to examine their effect on the estimates. Regardless of the prior assumptions, 22%–23% of elders were estimated to substitute formal services for informal care. Substitution was associated with greater demands on and lower availability of informal caregivers, occurring primarily in situations where the need for care exceeded the capacity of the informal care network. Imputation provided a straightforward means of estimating the probability of substitution among a subgroup of nonrespondents not represented among respondents. In addition, multiple imputation incorporated uncertainty about nonrespondent parameters.

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References

  • Doty, P. (1986). Family care of the elderly: The role of public policy. The Milbank Quarterly, 64, 34–75.

    Article  Google Scholar 

  • Fleiss, J.L. (1986). The Design and Analysis of Clinical Experiments. New York: John Wiley and Sons.

    MATH  Google Scholar 

  • General Accounting Office (1988). Long-Term Care for the Elderly: Issues of Need, Access, and Cost. GAO/HRD-89-4: Washington, D.C.

    Google Scholar 

  • Glynn, R.J., Laird, N.M. and Rubin, D.B. (1993). Multiple imputation In mixture models for nonignorable nonresponse with follow-ups. Journal of the American Statistical Association, 88, 984–993.

    Article  MATH  Google Scholar 

  • Hanley, R.J., Wiener, J.M. and Harris, K.M. (1991). Will paid home care erode informal support? Journal of Health Politics, Policy, and Law, 16(3), 507–521.

    Google Scholar 

  • Horowitz, A. (1985). Family caregiving to the frail elderly.Annual Review of Gerontology and Geriatrics, 5, 194–246.

    Google Scholar 

  • Horowitz, A. and Dobrof, R. (1982). The Role of Families in Providing Long-Term Care to the Frail and Chronically III Elderly Living in the Community. Health Care Financing Administration, USDHHS, Grant No. 18-P-97541/2–02.

    Google Scholar 

  • Hosmer, D.W. and Lemeshow, S. (1989). Applied Logistic Regression. New York: John Wiley and Sons.

    Google Scholar 

  • Jette, A.M., Tennstedt S., Crawford S. (1995). How does formal and informal community care affect nursing home use? Journal of Gerontology: Social Sciences, 50, S4–S12.

    Article  Google Scholar 

  • Little., R.J.A. (1993). Pattern-mixture models for multivariate incomplete data. Journal of the American Statistical Association, 88, 125–134.

    Article  MATH  Google Scholar 

  • Little, R.J.A. and Rubin, D.B. (1987). Statistical Analysis With Missing Data. New York: John Wiley and Sons.

    MATH  Google Scholar 

  • McKinlay, J.B. and Tennstedt S.L. (1986). Social Networks and the Care of Frail Elders. Final report to National Institute on Aging, Grant No. AG03869. Boston, MA: Boston University.

    Google Scholar 

  • Morris, J., Sherwood, S. and Mor, V. (1984). An assessment tool for use in identifying functionally vulnerable persons inlthe community. The Geron-tologist, 24, 373–379.

    Google Scholar 

  • Ries, P. and Brown, S. (1991). Disability and health: characteristics of persons by limitation of activity and assessed health status, United States, 1984–88. Advance data from vital and health statistics; no. 197. Hyattsville, MD: National Center for Health Statistics.

    Google Scholar 

  • Rubin, D.B. (1987). Multiple Imputation For Nonresponse in Surveys. New York: John Wiley and Sons.

    Book  Google Scholar 

  • Stone, R. and Kemper, P. (1989). Spouses and children of disabled elders: How large a constituency for long-term care reform? Milbank Memorial Quarterly, 67(3–4), 485–506.

    Google Scholar 

  • Tennstedt, S.L. and McKinlay, J.B. (1989). Informal care for frail older persons. In Aging and Health Care, eds. M. Ory and K. Bond. London: Routledge.

    Google Scholar 

  • Tennstedt, S.L., Crawford. S.L. and McKinlay, J.B. (1993a). Kinship tie versus co-residence: Predictors of patterns oi care. Journals of Gerontology: Social Sciences, 48, S74–S83.

    Google Scholar 

  • Tennstedt, S.L., Crawford. S.L. and McKinlay, J.B. (1993b). Is family care on the decline? A longitudinal investigation of the substitution of formal long-term care services for informal care. The Milbank Quarterly, 71(4), 1993.

    Article  Google Scholar 

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© 1995 Springer-Verlag New York, Inc.

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Crawford, S.L., Tennstedt, S.L., McKinlay, J.B. (1995). Longitudinal Care Patterns For Disabled Elders: A Bayesian Analysis of Missing Data. In: Gatsonis, C., Hodges, J.S., Kass, R.E., Singpurwalla, N.D. (eds) Case Studies in Bayesian Statistics, Volume II. Lecture Notes in Statistics, vol 105. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-2546-1_8

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  • DOI: https://doi.org/10.1007/978-1-4612-2546-1_8

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-94566-8

  • Online ISBN: 978-1-4612-2546-1

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