دانلود مقاله امید به زندگی در خانه سالمندان
چکیده
مدل تحلیل بقا
منبع داده ها و مشخصه هایی برای متغیرها
نتایج
خلاصه و نتیجه گیری
منابع
Abstract
The survival analysis model
Data source and specifications for the variables
The results
Summary and conclusions
Funding
References
چکیده
به خوبی شناخته شده است که امید به زندگی در خانه های سالمندان (NHs) برای سالمندان کمتر از کسانی است که در جاهای دیگر زندگی می کنند. در این مقاله، ما تلاش می‌کنیم تا میزان دقیق این از دست دادن امید به زندگی را کشف کنیم و اینکه آیا می‌توان آن را با شرایط سلامتی از قبل موجود، به‌ویژه جدی بودن زوال عقل توضیح داد. ما از یک مدل بقای پارامتریک، بر روی یک مجموعه داده بزرگ که تا 13 سال را شامل می‌شود، استفاده می‌کنیم که وضعیت سلامت و انواع محل سکونت را برای تمام دوره‌های زمانی تا زمانی که یک فرد بمیرد، پوشش می‌دهد. در صورت عدم کنترل وضعیت سلامت، از دست دادن امید به زندگی 47 ماه است. حسابداری برای وضعیت سلامت هنوز منجر به از دست دادن زندگی 41 ماهه می شود. حتی کسانی که دچار زوال عقل جدی هستند، اگر در NH ساکن نباشند، عمر طولانی تری خواهند داشت. سپس ما برای از دست دادن تخمینی سالهای زندگی ارزش گذاری می کنیم. خسارات بزرگ است، معادل 1.7 میلیون دلار برای هر ساکن NH و 1.87 تریلیون دلار برای جمعیت NH ایالات متحده.
توجه! این متن ترجمه ماشینی بوده و توسط مترجمین ای ترجمه، ترجمه نشده است.
Abstract
It is well known that life expectancy in nursing homes (NHs) is lower for older adults than those residing elsewhere. In this paper, we attempt to discover the exact extent of this loss of life expectancy, and whether it can be explained by pre-existing health state conditions, especially the seriousness of dementia. We use a parametric survival model, on a large data set spanning up to 13 years, which covers health states and types of residence for all time periods until a person dies. In the absence of health state controls, the loss of life expectancy is 47 months. Accounting for health states still leads to a 41-month loss of life. Even those with serious dementia would live longer lives if not residing in a NH. We then value the estimated loss of life years. The losses are large, equal to $1.7 million per NH resident, and $1.87 trillion for the US NH population.
Introduction
Life expectancy is rising in the US and around the world. Recently this increase has occurred more for the older age groups. Eggleston and Fuchs (2012) call this recent increase in life expectancy for older adults ‘the new demographic transition’. As the population ages, more and more people will be seeking long-term care. A central part of this process involves the moving from living at home with caregiver support, to living in an institution where medical services and treatment carried out by skilled nurses and physicians are the main priority. We will refer to such medically staffed institutions as nursing homes (NH), while recognizing that there could be a wide range of medical expertise being provided under that heading.1 With this movement into NHs, where health services are more available, there is the expectation that life expectancy will be further extended. With this expectation, it seems somewhat surprising to learn that the mortality rate over the first year of nursing home residence was 35.0%, with 16.3% deaths occurring within 100 days, Shuang et al. (2018).
Summary and conclusions
It is now well known that life expectancy declines when someone is admitted to a NH. The appropriate research questions involve trying to find out the extent of this decline, and attempting to understand why this decline takes place. In this paper, we presented evidence that the life expectancy decline is large, amounting to 45 months. This initial estimate does not control for any factors that are known to affect life expectancy, such as a person’s health state.