The Effects of Home Care Provider Mix on the Care Recipient: An International, Systematic Review of Articles from 2000 to 2020
In this systematic review, we examine the literature from 2000 to 2020 to ascertain whether we can make strong conclusions about the relative benefit of adding informal care or formal care providers to the care mix among individuals receiving care in the home, specifically focusing on care recipient outcomes. We evaluate how informal care and formal care affect (or are associated with) health care use of care recipients, health care costs of care recipients, and health outcomes of care recipients. The literature to date suggests that informal care, either alone or in concert with formal care, delivers improvements in the health and well-being of older adults receiving care. The conclusions one can draw about the effects of formal care are less clear.
Coe NB, Konetzka RT, Berkowitz Melissa, Blecker Emily, Van Houtven CH: The Effects of Home Care Provider Mix on the Care Recipient: An International, Systematic Review of Articles from 2000 to 2020, Annual Review of Public Health, 42(1), Jan 2021.
Rates of informal home care use among older adults with disabilities increased from 2004 to 2016, such that in 2016 almost three-quarters of these adults received informal home care. Informal care remains the most common source of home care, even though formal home care use grew at almost twice the rate, with a 6-percentage-point increase to 36.9 percent in 2016.
Van Houtven CH, Taggert E, Konetzka RT, Coe NB: Informal and Formal Home Care Both Increased Between 2004 and 2016, Potentially Reducing Unmet Needs of Older Adults (Data Watch). Health Affairs. August 2020.
A perspective piece discussing how COVID19 has further destabilized nursing homes and offering suggestions for how to improve long term care post-pandemic.
Werner R, Hoffman A, Coe NB: Long-Term Care Policy after Covid-19 - Solving the Nursing Home Crisis. (Perspective) The New England Journal of Medicine 382(22), May 2020.
Descriptive article covering the risk of COVID transmission in assisted living, independent living, and continuing care retirement communities.
Coe NB, Van Houtven CH. “Living Arrangements of Older Adults and COVID Risk: It is Not Just Nursing Homes.” Journal of the American Geriatrics Society. 2020. May. PMID: 32359073
Essential Long-Term Care Workers Commonly Hold Second Jobs and Double- or Triple-Duty Caregiving Roles
Long-term care (LTC) facilities are particularly dangerous places for the spread of COVID-19 given that they house vulnerable high-risk populations. Transmission-based precautions to protect residents, employees, and families alike must account for potential risks posed by LTC workers’ second jobs and unpaid care work. This observational study describes the prevalence of their (1) second jobs, and (2) unpaid care work for dependent children and/or adult relatives (double- and triple-duty caregiving) overall and by occupational group (registered nurses [RNs], licensed practical nurses [LPNs], or certified nursing assistants [CNAs]). The data used was a descriptive secondary analysis of data collected as part of the final wave of the Work, Family, and Health Study. Findings show that LTC workers commonly hold second jobs along with double- and triple-duty caregiving roles. To slow the spread of COVID-19, both the paid and unpaid activities of these employees warrant consideration in the identification of appropriate clinical, policy, and informal supports.
Van Houtven CH, DePasquale N, Coe NB: Essential Long-Term Care Workers Commonly Hold Second Jobs and Double- or Triple-Duty Caregiving Roles. Journal of the American Geriatrics Society Apr 2020.
What is the marginal benefit of payment‐induced family care? Impact on Medicaid spending and health of care recipients
Research on home‐based long‐term care has centered almost solely on the costs; there has been very little, if any, attention paid to the relative benefits. This study exploits the randomization built into the Cash and Counseling Demonstration and Evaluation program that directly impacted the likelihood of having family involved in home care delivery. They find that some family involvement in home‐based care significantly decreases health‐care utilization: lower likelihood of emergency room use, Medicaid‐financed inpatient days, any Medicaid hospital expenditures, and fewer months with Medicaid‐paid inpatient use. We find that individuals who have some family involved in home‐based care are less likely to have several adverse health outcomes within the first 9 months of the trial, including lower prevalence of infections, bedsores, or shortness of breath, suggesting that the lower utilization may be due to better health outcomes.
Coe, NB, J Guo, RT Konetzka, CH Van Houtven. “What is the Marginal Benefit of Payment-Induced Family Care?” Health Economics. 2019, 28(5); 678-692 (Also appeared as NBER Working Paper 22249).
A Comprehensive Measure of the Costs of Caring for a Parent: Differences According to Functional Status
Coe, NB, M.M. Skira, and E.B. Larson. “A Comprehensive Measure of the Costs of Caring for a Parent: Differences According to Functional Status.” Journal of the American Geriatrics Society 2018. 66(10). PMCID: PMC6181761
Khandelwal N, D Benkeser, NB Coe, RA Engelberg, JM Teno, JR Curtis. “Patterns of Cost for Patients Dying in the ICU and Implications for Cost Savings of Palliative Care Interventions.” Journal of Palliative Medicine. 2016. November, 19(11): 1171-1178. doi:10.1089/jpm.2016.0133.
Geographic Migration Among Residents in Seniors Housing and Care Communities: Evidence From the Residents Financial Survey
Coe, NB, and AY Wu. “Geographic Migration among Residents in Seniors Housing and Care Communities: Evidence from the Residents Financial Survey.” Journal of Housing for the Elderly. 2016. 30(3): 312-329, DOI: 10.1080/02763893.2016.1198741
Broyles, I, NR Sperber, NB Coe, RT Konetzka, CI Voils, CH Van Houtven. “Understanding the Context for Long-Term Care Planning” Medical Care Research and Review 2016. 73(3) 349-368 PMID: 26553887.