overview of the national long term care survey (nltcs)
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Overview of the National Long Term Care Survey (NLTCS). Conference on Chinese Healthy Aging and Socioeconomic Development Durham, NC August, 2004 Nicholas Holt. Topic Guide. Survey Objectives Background Survey Design Survey Content Innovations Research Results. Objectives. - PowerPoint PPT PresentationTRANSCRIPT
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Overview of the National Long Term Care Survey (NLTCS)
Conference on Chinese Healthy Aging and Socioeconomic Development
Durham, NCAugust, 2004
Nicholas Holt
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Topic Guide Survey Objectives Background Survey Design Survey Content Innovations Research Results
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Objectives NLTCS – to characterize the health
and functional status of the population 65 years and older
Informal Caregiver Survey – to examine how family and social relations help chronically disabled persons function in the community
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Background
Established in 1982 as a cross-sectional survey
Sponsored by HCFA in 1982-1984 Picked up by NIA and the Center for
Demographic Studies in 1989 Additional Funding from ASPE in all
waves beginning in 1989
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Background Has both longitudinal and cross-sectional
aspects Waves are nominally 5 years apart Particular emphasis on functionally
impaired individuals
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Background Nationally representative measures of:
Longitudinal and cohort patterns of change in functional limitation
Mortality Health care and other services, formal and
informal, received by impaired How care is paid for
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Design of Survey Entire sample gets a screener
interview Disabled get a detailed interview
Community Institutional
Disability is defined by the screener interview
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The Sample A probability sample of persons
aged 65 and older
Added in groups over time (healthy supplement)
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The Sample (1) 1982
a probability sample from the MEDICARE files large enough to yield 6000 community disabled people (~35,000)
conceived as a cross-sectional survey Census Bureau drew the sample and
conducted the actual interviews
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The Sample (2) 1984
Sample included all community and institutional disabled plus a probability sample of the non-disabled from 1982 sample
plus a probability sample from all who became 65 years old since 1982
Census Bureau drew the probability sample and conducted the actual interviews
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The Sample (3) 1989 - on
Sample included all disabled who were disabled in the prior wave plus some or all of the non-disabled from prior wave
plus a probability sample from all who became 65 years old since previous wave
Census Bureau drew the probability sample and conducted the actual interviews
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Sample SizesInterview 1982 1984 1989 1994 1999 200
4Screener 11,57
013,78
610,33
010,47
411,00
2Community 6,088 5,954 4,463 5,089 5,147Institutional 1,992 1,773 1,354 1,330 1,036
Ancillary
Caregiver 1,007 1,600Next-of-Kin 3,219 544Venipuncture 639
Buccal 2,083
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Survey Content Questionnaire content came from several sources Questions
Disability, medical conditions, physical functioning, cognitive functioning
Caregivers Nutrition, perceived health status Living arrangements, income, and education
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Screener Interview Primarily done by phone Determines whether or not the
subject gets a detailed interview Determines whether subject gets a
community interview or an institutional detailed interview
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Detailed interview questions Medical conditions
Disability (ADL & IADL)
Range of motion and impairment
Cognitive functioning
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Detailed interview questions Insurance Income Children and siblings Medical providers and prescription
drugs
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Detailed interview questions Helpers Caregiver selection Nutrition and social activities Institutional
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Demographic Variables Demographic and economic characteristics
age, race, sex, marital status education, income and assets, housing and
neighborhood characteristics
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Innovations Added a sample of caregivers
starting in in 1989 Starting in 1994 a sample of non-
disabled screen-outs were interviewed
Starting in 1994 a supplementary sample of 95+ was added
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Supplemental Surveys Next-of-Kin Mortality Follow Up
(1984 and 2000) Biological Specimens
638 bloods in 1999 1172 buccal washes in 1999 3000 bloods planned in 2004 1000 buccal washes planned in 2004
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Medicare Data Survey data supplemented with linked
Medicare claims history from CMS for each survey participant
Medicare data linked to NLTCS survey data and furnished to CMS
Researchers must obtain Medicare data directly from CMS
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Research Results Chronic disability Severe cognitive impairment Medicare expenditures Genetic studies
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Possible Research Areas Function limitations, physical and cognitive Patterns of change Medical conditions Health care services used Caregiver assistance Demographic and economic characteristics Out of pocket expenditures
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Survey Data Survey data can be obtained from CDS or,
with some added value from Unicon, Inc. http://www.unicon.com/
In either case the DUA will be signed with CDShttp://nltcs.cds.duke.edu/index.htm