Monthly on the 3rd Thursday
8am US Pacific Time, 11am US Eastern Time, 5pm Central European Time

The Gateway to Global Aging, in partnership with the Center to Accelerate Population Research in Alzheimer’s (capra.med.umich.edu), is organizing a monthly virtual seminar series on long-term care, services, and policy. The seminar series is led by Julien Bergeot and Giacomo Pasini from Ca' Foscari University of Venice. The goal of the seminar series is to promote international interactions among scholars in this growing field of research. Presentations will typically be on in-progress work and discussions are strongly encouraged.

Participants must register to receive upcoming seminar announcements and virtual meeting room links. To register please submit a form with your email here. Emails will be kept limited to seminar announcements and you can unsubscribe from this list at any time.

Presentations will resume in the Fall of 2024

• September 19, 2024
  Bram Wouterse, Erasmus School of Health Policy & Management (joint work with Prithviraj Basu Mallik and Pieter Bakx)
  "Preventing Nursing Home Use: Is State-Sponsored Spending for Social Care a Winning Formula?"
  Objectives: We aim to identify whether providing funds for social support to municipalities leads to less nursing home admissions. Social support can prevent nursing home use through customized home facilities and support with activities of daily living. To prevent nursing home use, investments in social caret can be a useful policy instrument. The Dutch government can only stimulate expenditure in social care by providing non-earmarked funds to municipalities. Consequently, important questions are: does providing extra funds to municipalities for increases social care provision? And if so, does social Care use lower nursing home use?
  Methods: We use administrative individual-level panel data (2015–2021) from Statistics Netherlands for the entire Dutch population 65 years and older, with detailed information on health, disability and health care use. We use an instrumental variable approach to identify the causal effect of social care provision on nursing home use. Municipalities receive non-earmarked funds based on an allocation model that does not take important determinants of care need into account. Using detailed individual data we predict care the number of potential clients per municipality and identify the variation in the available budget per potential client across municipalities. We use this variation as an instrument for the provision of social care support across municipalities.
  Results: Correcting for need, we find substantial variation in the government contribution for social care per potential client across Dutch municipalities. Although the government contribution is unearmarked, there is a strong positive relation between the allocated budget per potential users and the number of actual users: per 1000 euro extra budget per potential client, the share of social care users among the 65-plus population in a municipality increases by 8 percentage points. Additional spending on social care prevent the use of nursing home care: for every 100 addition users of WMO care in a year, 13 people less are admitted to a nursing home care.
  Conclusions: There are three notable findings. First, there is substantial variation in the distribution of funds across municipalities compared to the need for social care. Second, providing extra funds to municipalities increases social care utilisation. Finally, there is a corresponding decrease in nursing home admissions providing support for social care as a method to control long term care expenses.

• October 10, 2024 *special date
  Chuxuan Sun, University of Pennsylvania
  "The costs of AD/ADRD by dementia subtype: Evidence from ACT"
  Background: Existing studies on the health care utilization and costs associated with Alzheimer’s disease (AD) have treated individuals with AD as a homogeneous group, though recent evidence suggests individuals with AD may be classified into biologically distinct subgroups with differing genetic and clinical profiles. The objective of our study is to examine differences in health care utilization and costs across cognitively-defined AD subgroups.
  Methods: We utilize data from the Adult Changes in Thought (ACT) study (1994 – 2020), a population-based longitudinal study of aging and the incidence of and risk factors for dementia. We focus our study on individuals who developed incident AD and classify these individuals into one of six cognitively-defined AD subgroups using previously described methods. We identify a sex- and birth year-matched set of controls using a many-to-one matching method. Controls are assigned an index date equal to the AD onset date for their matched AD case. We examine utilization and costs in the year preceding AD onset and in the three years following. Our utilization outcomes include number of days in a month spent in a hospital inpatient, intensive care unit, or skilled nursing facility setting, and number of emergency department visits. We also examine monthly total health care costs and component costs, including outpatient, hospital inpatient, skilled nursing facility, and pharmacy costs. We utilize repeated measures generalized estimating equations to estimate health care utilization associated with each AD subgroup. To estimate the incremental costs associated with each subgroup, we use the Basu and Manning cost estimator.
  Results: We find significant utilization and costs differences across the cognitively-defined AD subgroups, driven primarily by differences in the use of hospital inpatient and skilled nursing facility services. We also find the highest utilization and costs among the group of individuals with substantial relative impairments across multiple cognitive domains.
  Conclusions: Studies on the health care utilization and costs associated with AD miss important heterogeneity by examining individuals with AD in the aggregate. Our study suggests that individuals in the cognitively-defined AD subgroups have distinct health care utilization and cost patterns leading up to and following AD onset.

Thank you to those who have already presented:

• April 18, 2024
  Meghan Skira, University of Georgia
  "Genetic Risk for Alzheimer’s Disease and Related Dementias: Cognition, Economic Behavior, and Clinically Actionable Information"
• March 21, 2024
  Sung Ah Bahk, American University (joint work with Selin Secil Akin, Lidia Brun, Ignacio Gonzalez, and Aina Puig)
  "Universal Long-term Care Reform and the Labor Supply of Caregivers: Evidence from Korea"
• January 19, 2023
  Julien Bergeot of the Department of Economics, Ca’ Foscari University of Venice (joint work with Louis Arnault)
  "Informal Care & Mental Health: A Story of Unobserved Heterogeneity"
• February 16, 2023
  Marlies Bär of the Erasmus School of Health Policy & Management, Erasmus University Rotterdam (joint work with Pieter Bakx, Nigel Rice, Rita Santos, Luigi Siciliani, and Bram Wouterse)
  "Spillovers of Delayed Nursing Home Admissions to the Hospital Sector"
• March 16, 2023
  Edward Norton, University of Michigan
  "Did Avoiding Post-Acute SNF Care During COVID Save Lives?"
• April 20, 2023
  Ingo Kolodziej of RWI Essen (joint work with Norma B. Coe of the University of Pennsylvania and Courtney H. Van Houtven of Duke University)
  "Intensive Informal Care and Impairments in Work Productivity and Activity"
• May 18, 2023
  Joan Costa-i-Font, London School of Economics
  "Are Long term care subsidies and supports productive? Effects on health and wellbeing"
• September 21, 2023
  Elsa Perdrix, Paris Dauphine University
  "Horizontal Inequity in Long-term Care Use in France"
• October 19, 2023
  Bertrand Achou, University of Groningen
  "At Home versus in a Nursing Home: Long-term Care Settings and Marginal Utility"
• November 16, 2023
  R. Tamara Konetzka, University of Chicago
  "The Role of Medicaid Home- and Community-Based Services in Use of Medicare Post-Acute Care"
• Dec 14, 2023
  Anne Penneau, Institute for Research and Information in Health Economics
  "The Impact of Nursing Homes on Quality of Drug Prescription in France"
• February 15, 2024
  Helena M. Hernandez-Pizarro, Pompeu Fabra University
  "Unravelling Hidden Inequities in a Universal Public Long-Term Care System"
• May 16, 2024
  Wenhan Zhang, Duke University
  "Trends in Quality of Life Indicators for Older Adults with Cognitive Impairment Across Living and Care Arrangements from 2008 to 2020: A Population-Based Descriptive Study"