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Impact of Medicare eligibility on informal caregiving for surgery and stroke
dc.contributor.authorDe Roo, Ana C.
dc.contributor.authorHa, Jinkyung
dc.contributor.authorRegenbogen, Scott E.
dc.contributor.authorHoffman, Geoffrey J.
dc.date.accessioned2023-02-01T18:57:09Z
dc.date.available2024-03-01 13:57:08en
dc.date.available2023-02-01T18:57:09Z
dc.date.issued2023-02
dc.identifier.citationDe Roo, Ana C.; Ha, Jinkyung; Regenbogen, Scott E.; Hoffman, Geoffrey J. (2023). "Impact of Medicare eligibility on informal caregiving for surgery and stroke." Health Services Research 58(1): 128-139.
dc.identifier.issn0017-9124
dc.identifier.issn1475-6773
dc.identifier.urihttps://hdl.handle.net/2027.42/175739
dc.description.abstractObjectiveTo assess whether the intensity of family and friend care changes after older individuals enroll in Medicare at age 65.Data SourcesHealth and Retirement Study survey data (1998–2018).Study DesignWe compared informal care received by patients hospitalized for stroke, heart surgery, or joint surgery and who were stratified into propensity-weighted pre- and post-Medicare eligibility cohorts. A regression discontinuity design compared the self-reported likelihood of any care receipt, weekly hours of overall informal care, and intensity of informal care (hours among those receiving any care) at Medicare eligibility.Data CollectionNot applicable.Principal FindingsA total of 2270 individuals were included; 1674 (73.7%) stroke, 240 (10.6%) heart surgery, and 356 (15.7%) joint surgery patients. Mean (SD) care received was 20.0 (42.1) weekly hours. Of the 1214 (53.5%) patients who received informal care, the mean (SD) care receipt was 37.4 (51.7) weekly hours. Mean (SD) overall weekly care received was 23.4 (45.5), 13.9 (35.8), and 7.8 (21.6) for stroke, heart surgery, and joint surgery patients, respectively. The onset of Medicare eligibility was associated with a 13.6 percentage-point decrease in the probability of informal care received for stroke patients (p = 0.003) but not in the other acute care cohorts. Men had a 16.8 percentage-point decrease (p = 0.002) in the probability of any care receipt.ConclusionsMedicare coverage was associated with a substantial decrease in family and friend caregiving use for stroke patients. Informal care may substitute for rather than complement restorative care, given that Medicare is known to expand the use of postacute care. The observed spillover effect of Medicare coverage on informal caregiving has implications for patient function and caregiver burden and should be considered in episode-based reimbursement models that alter professional rehabilitative care intensity.
dc.publisherBlackwell Publishing Ltd
dc.publisherWiley Periodicals, Inc.
dc.subject.otherstroke
dc.subject.otherdiscontinuity
dc.subject.othercaregiving
dc.subject.othersurgery
dc.subject.otherMedicare
dc.titleImpact of Medicare eligibility on informal caregiving for surgery and stroke
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelPublic Health
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/175739/1/hesr14019.pdf
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/175739/2/hesr14019_am.pdf
dc.identifier.doi10.1111/1475-6773.14019
dc.identifier.sourceHealth Services Research
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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