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Informal care of elderly parents by adult children limits use of nursing home and other formal care and shortens hospital stays

Informal care of the elderly by their adult children reduces use of formal home health care and nursing home care and shortens hospital stays, according to a study supported in part by the Agency for Healthcare Research and Quality (T32 HS00032). For example, elderly parents who received no informal care were predicted to stay in the hospital for an average of 7 nights, while parents who received 20 hours per month (the median level) of informal care were predicted to stay for only 2.4 nights. Also, those receiving no informal care had more physician visits than those receiving median levels of informal care (2.5 vs. 1), except for those undergoing outpatient surgery.

A 2-hour increase in median informal care hours per month meant a decrease of 7.43 percent in the likelihood of home health care use. A 10 percent increase in monthly informal care hours reduced by 2 days the 25-night mean nursing home stay over a 2-year period. Thus, whether or not adult children care for their parents in the future will have large implications for the long-term care services that will be needed in the United States over the next 50 years, according to Courtney H. Van Houtven, Ph.D., of Duke University Medical Center, and Edward C. Norton, Ph.D., of the University of North Carolina at Chapel Hill.

Focusing on plausible estimates of publicly funded home health care and nursing home care only, the researchers showed in policy simulations that increasing the caregiving margins of an adult child who was not previously working would save Medicare and Medicaid from $350 to $1000. Their findings are based on an analysis of the 1998 Health and Retirement Survey and the 1995 Asset and Health Dynamics among the Oldest-Old Panel Survey.

Details are in "Informal care and health care use of older adults," by Drs. Van Houtven and Norton, in the Journal of Health Economics 23, pp. 1159-1180, 2004.

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