Current Awareness in Aging Research (CAAR) Report #20--February 10, 2000

CAAR (Current Awareness in Aging Research) is a weekly email report produced by the Center for Demography of Health and Aging at the University of Wisconsin-Madison that helps researchers keep up to date with the latest developments in the field. For more information, including an archive of back issues and subscription information see:

http://www.ssc.wisc.edu/cdha/caar/caar-index.htm

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I. Data:

1. ICPSR: MIDUS CORRECTION: NATIONAL SURVEY OF MIDLIFE DEVELOPMENT IN THE UNITED STATES (MIDUS), 1995-1996 (#2760). The Inter-University Consortium for Political and Social Research announced Feb. 1, 2000 that it had replaced the SAS transport file for Part 1, Main Data, because the original version contained an incorrect number of cases.

http://www.icpsr.umich.edu/recupd.html

and scroll to NATIONAL SURVEY OF MIDLIFE DEVELOPMENT IN THE UNITED STATES (MIDUS), 1995-1996.
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2. GPO: The Government Printing Office has recently made the following data available for purchase on CD-ROM. For more information, including price and ordering information, see the below listed Internet addresses.

A. National Ambulatory Medical Care Survey (1997).

http://www.access.gpo.gov/su_docs/sale/cdrom197.html

B. National Center for Health Statistics (NCHS) Publications, featuring _Health, United States_ (1996-97).

http://www.access.gpo.gov/su_docs/sale/cdrom164.html
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3. CENSUS BUREAU: The Census Bureau is offering free copies of the 1998 American Community Survey on CD-ROM. Data are available in the following formats: community profiles, detailed summary tables, and public-use microdata. "The American Community Survey is designed to replace the long-form questionnaire in the 2010 census."

http://www.census.gov/Press-Release/www/2000/cb00cn13.html

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II. Reports and articles

4. OMB FY2001 FEDERAL BUDGET: The Office of Management and Budget has released the FY 2001 Budget and related documents (HTML, .pdf, and Excel or Lotus spreadsheet formats). Budgets back to 1996 are available at the site.

http://w3.access.gpo.gov/usbudget/index.html
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5. HHS OIG OAS REPORTS: The Office of Audit Services of the Office of the Inspector General of the Department of Health and Human Services has recently released the following reports:

A. "Administrative Costs Reflected on the Adjusted Community Rate Proposals Are Inconsistent Among Managed Care Organizations" (A-14-98-00210, January 2000, .pdf format, 23p.).

>From the Abstract:

This final report points out that administrative costs claimed by 232 risk-based managed care organizations (MCO) on their adjusted community rate (ACR) proposals for each of the years 1996 through 1999 contained significant disparities among plans. For example, for 1999 the average amount allocated by an MCO for administration ranged from a high of 32 percent to a low of 3 percent. These disparities were noted in every year of our review regardless of plan model (group, individual practice association, or staff) or tax status (profit or nonprofit). Unlike other areas of the Medicare program, a reasonable percentage or ceiling for an administrative cost rate is not required by the Health Care Financing Administration (HCFA). We recommended that HCFA institute a ceiling on the amount of administrative costs that MCOs can claim on ACR proposals. For example, had a 15 percent ceiling been in effect for 1998, an additional $1 billion may have been passed on to Medicare beneficiaries in the form of additional benefits or reduced payments (e.g., deductibles and/or co-insurance). The HCFA agreed that a more thorough analysis of ACR proposals should be performed, but did not concur with our recommendation of setting a ceiling on administrative costs, claiming that a ceiling may discourage plans from developing cost efficient plans.

http://www.hhs.gov/progorg/oas/reports/hcfa/b9800210.pdf

B. "Review of the Administrative Cost Component of the Adjusted Community Rate Proposal at Nine Medicare Managed Care Organizations for the 1997 Contract Year," (A-03-98-00046, January 2000, .pdf format, 26p.).

>From the Abstract:

This final report points out that the Health Care Financing Administration's (HCFA) methodology for developing adjusted community rate proposals (ACRP) (developed by managed care organizations (MCO) to claim administrative costs) results in Medicare paying a disproportionate share of such costs. Five of the nine MCOs included in our reviews overestimated their administrative costs by an average of 100 percent. The five MCOs proposed costs totaling $231.9 million and incurred costs totaling only $115.7 million, for an excess of $116.2 million. Further, the nine MCOs claimed $66.3 million which would have been recommended for disallowance had the MCOs been required to follow Medicare's general principle of paying only reasonable costs. We recommended that HCFA pursue legislation that would require MCOs to follow Medicare's general principle of paying only reasonable costs or establish a cap on administrative costs. We also recommended that HCFA consider publishing the administrative cost rates of all MCOs participating in the Medicare program. This would provide information to Medicare beneficiaries aimed at helping them become more educated consumers of health care services.

http://www.hhs.gov/progorg/oas/reports/region3/39800046.pdf
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6. MEDSCAPE ARTICLES: Note: Medscape requires free registration before providing articles.

A. _Ear, Nose & Throat Journal_ (via Medscape) Article: "Equilibrium and Balance in the Elderly," by Claude P. Hobeika. (HTML format, _Ear, Nose and Throat Journal_, 78(8):558-566, 1999).

>From the Abstract:

Complaints of dizziness and disequilibrium increase with age. Sixty-five percent of individuals older than 60 years of age experience dizziness or loss of balance, often on a daily basis. Some degree of imbalance is present in all individuals older than 60. This is the result of a generalized functional degradation. Initially, the imbalance is situational and manifests when the righting reflexes cannot meet the demands of a challenging environment, such as a slippery surface. As the functional degradation progresses, the imbalance occurs during everyday activities, independent ambulation becomes difficult, and the likelihood of falls increases. When instability is constant, the individual resorts to the use of a cane, a walker, or a wheelchair.

http://www.medscape.com/medquest/ENT/1999/v78.n08/ent7808.09.hobe/ent7808.09.hobe-01.html

B. Medscape Nursing Expert Column: "The Balanced Budget Act of 1997: Reimbursement and the Advanced Practice Nurse," by William J. Mazzocco Jr., (Medscape Nursing, 2000, HTML format).

>From the Introduction:

All advanced practice nurses (APNs) who see Medicare patients must make certain they are following the new rules and regulations that evolved from the Balanced Budget Act of 1997. The costs of not knowing are very high and have both personal and professional ramifications.... This one Congressional decision has done more to influence the course of advanced practice nursing than has any other single piece of legislation. Most practitioners are familiar with the statements made in the act, but the ramifications of those statements may not be obvious. Failure to understand what these changes actually mean can only lead to confusion for the neophyte provider about reimbursement and legal issues.

http://www.medscape.com/Medscape/Nurses/journal/2000/v02.n01/mns0128.mazz/mns0128.mazz.html
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7. GAO REPORTS:

A. "Adverse Drug Events: The Magnitude of Health Risk Is Uncertain Because of Limited Incidence Data" (HEHS-00-21, January 2000, .pdf format, 51p.).

http://www.gao.gov/new.items/he00021.pdf

B. "Medicare: Lessons Learned From HCFA's Implementation of Changes to Benefits" (HEHS-00-31, January, 2000, .pdf format, 26p.).

http://www.gao.gov/new.items/he00031.pdf

Note: GAO Internet addresses are valid for only a limited period of time. After that time, documents can be found by searching the Government Printing Office:

http://www.access.gpo.gov/su_docs/aces/aces160.shtml

and searching on title or report number.
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8. NIA PRESS RELEASES (VIA ADRC): The Alzheimer's Disease and Referral Center has posted the following National Institute on Aging Press Releases:

A. "Low-dose Prednisone Found Ineffective Against Alzheimer's Disease; Researchers Continue to Look at NSAIDs, Other Drugs" (Feb. 8, 2000).

http://www.alzheimers.org/nianews/nianews26.html

B. "NIA To Study COX-2 Inhibitor, Other NSAID as New Treatment for Alzheimer's Disease" (Feb. 8, 2000).

http://www.alzheimers.org/nianews/nianews25.html
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9. _JAMA_ ARTICLE: "End-of-Life Care Content in 50 Textbooks From Multiple Specialties," by Michael W. Rabow, Grace E. Hardie, Joan M. Fair, and Stephen J. McPhee. (_Journal of the American Medical Association_, Feb. 9, 2000, 283:771-778).

>From the Abstract:

Context: Prior reviews of small numbers of medical textbooks suggest that end-of-life care is not well covered in textbooks. No broad study of end-of-life care content analysis has been performed on textbooks across a wide range of medical, pediatric, psychiatric, and surgical specialties. Objective: To determine the quantity and rate the adequacy of information on end-of-life care in textbooks from multiple medical disciplines. Conclusion: Top-selling textbooks generally offered little helpful information on caring for patients at the end of life. Most disease-oriented chapters had no or minimal end-of-life care content. Specialty textbooks with information about particular diseases often did not contain helpful information on caring for patients dying from those diseases.

http://jama.ama-assn.org/issues/v283n6/full/joc91365.html
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10. _MAYO CLINIC PROCEEDINGS_ ARTICLE AND EDITORIAL:

A. "Optimists vs Pessimists: Survival Rate Among Medical Patients Over a 30-Year Period," by Toshihiko Maruta, Robert C. Colligan, Michael Malinchoc, and Kenneth P. Offord (_Mayo Clinic Proceedings_, Vol. 75, No. 2, p.140-143, .pdf format).

>From the Abstract:

Objective: To examine explanatory style (how people explain life events) as a risk factor for early death, using scores from the Optimism-Pessimism scale of the Minnesota Multiphasic Personality Inventory (MMPI). Subjects and Methods: A total of 839 patients completed the MMPI between 1962 and 1965 as self-referred general medical patients. Thirty years later, the vital status of each of these patients was ascertained. Conclusion: A pessimistic explanatory style, as measured by the Optimism-Pessimism scale of the MMPI, is significantly associated with mortality.

http://www.mayo.edu/pub-rst/proceedings/2000/feb/7502a1.pdf

B. "Optimism, Pessimism, and Mortality," by Martin E. P. Seligman (_Mayo Clinic Proceedings_, Vol. 75, No. 2, p.133-134, .pdf format).

http://www.mayo.edu/pub-rst/proceedings/2000/feb/7502e1.pdf

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III. Working Papers

11. NBER PAPERS IN AGING: The National Bureau of Economic Research has released the following Papers in Aging:

A. "The Progressivity of Social Security," by Julia Lynn Coronado, Don Fullerton, and Thomas Glass (W7520, February 2000, .pdf format, 46p.).

>From the Abstract:

How much does the current social security system really redistribute from rich to poor? We use the PSID to estimate lifetime wage profiles and actual earnings each year for a sample of 1778 individuals, and we use mortality probabilities to calculate expected payroll taxes and social security benefits. For a given set of facts' about the net flows received by each individual, measured progressivity depends on many assumptions. This paper attempts to capture and to quantify all of the individual characteristics that are relevant to determine the progressivity of a life-cycle program like social security. We proceed in seven steps. First, we classify individuals by annual income and use Gini coefficients to find that social security is highly progressive. Second, we reclassify individuals on the basis of lifetime income and find that social security is less progressive. Third, we remove the cap on measured earnings and find that social security is even less progressive. Fourth, we switch from actual to potential lifetime earnings (the present value of the wage rate times 4000 hours each year). This measure captures the value of leisure and home production, so those out of the labor force are less poor, and net payments to them are less progressive. Fifth, we assign to each married individual half of the couple's income. The low-wage spouse is then not so poor and social security becomes even less progressive. Sixth, we incorporate mortality probabilities that differ by potential lifetime income. Since the rich live longer and collect benefits longer, social security is no longer progressive. Finally, we increase the discount rate from 2% to 4%, which puts relatively more weight on the earlier-but-regressive payroll tax and less weight on the later-but-progressive benefit schedule. The whole social security system is then regressive.

http://papers.nber.org/papers/W7520

B. "Choice, Chance, and Wealth Dispersion at Retirement," by Steven F. Venti and David A. Wise (W7521, February 2000, .pdf format, 69p.).

>From the Abstract:

"People earn just enough to get by" is a phrase often used to explain the low personal saving rate in the United States. The implicit presumption is that households simply do not earn enough to pay for current needs and to save. We show in this paper that at all levels of lifetime earnings there is an enormous dispersion in the accumulated wealth of families approaching retirement. It is not only households with low incomes that save little; a significant proportion of high income households also saves little. And, a substantial proportion of low income households save a great deal. We then consider the extent to which differences in household lifetime financial resources explain the wide dispersion in wealth, given lifetime earnings. We find that very little of this dispersion can be explained by chance differences in individual circumstances - " largely outside the control of individuals" - that might limit the resources from which saving might plausibly be made. We also consider how much of the dispersion in wealth might be accounted for by different investment choices of savers some more risky, some less risky given _lifetime_ earnings. We find that investment choice is not a major determinant of the dispersion in asset accumulation. It matters about as much as chance events that limit the available resources of households with the same lifetime earnings. We conclude that the bulk of the dispersion must be attributed to differences in the amount that households choose to save. The differences in saving choices among households with similar lifetime earnings lead to vastly different levels of asset accumulation by the time retirement age approaches.

http://papers.nber.org/papers/W7521

C. "How Large is the Bias in Self-Reported Disability?" by Hugo Benitez-Silva, Moshe Buchinsky, Hiu Man Chan, Sofia Cheidvasser, and John Rust (W7526, February 2000, .pdf format, 47p.).

>From the Abstract:

A pervasive concern with the use of self-reported health and disability measures in behavioral models is that they are biased and endogenous. A commonly suggested explanation is that survey respondents exaggerate the severity of health problems and incidence of disabilities in order to rationalize labor force non-participation, application for disability benefits and/or receipt of those benefits. This paper re-examines this issue using a self-reported indicator of disability status from the Health and Retirement Survey. Using a bivariate probit model we test and are unable to reject the hypothesis that the self-reported disability measure is an exogenous explanatory variable in a model of individual's decision to apply for DI benefits or Social Security Administration's decision to award benefits. We further study a subsample of individuals who applied for Disability Insurance and Supplemental Security Income benefits from the Social Security Administration (SSA) for whom we can also observe SSA's award/deny decision. For this subsample we test and are unable to reject the hypothesis that self-reported disability is health and socio-economic characteristics similar to the information used by the SSA in making its award decisions. The unbiasedness restriction implies that these two variables have the same conditional probability distributions. Thus, our results indicate that disability applicants do not exaggerate their disability status at least in anonymous surveys such as the HRS. Indeed, our results are consistent with the hypothesis that disability applicants are aware of the criteria and decision rules that SSA uses in making awards and act as if they were applying these same criteria and rules when reporting their own disability status.

http://papers.nber.org/papers/W7526
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12. INSTITUTE FOR FISCAL STUDIES (UK): "Wages and the Demand for Health - A Life Cycle Analysis," by Christiann Dustmann and Frank Windmeijer (IFS Working Paper W99/20, August 1999, .pdf format, 36p.).

>From the Abstract:

This paper presents a life cycle model for the demand for health, and derives empirical specifications that distinguish between permanent and transitory wage responses. Using panel data, we estimate dynamic health and health input demand equations. We find evidence of negative transitory wage effects, and positive permanent effects. Our results emphasise the importance to analyse health related behaviour in a dynamic life cycle context. The report uses data from the German Socio-Economic Panel and covers the period between 1984 and 1995.

http://www1.ifs.org.uk/research/workingpapers/wp9920.pdf

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IV. Journal Tables of Contents (check your library for availability)

13. CARL Uncover Journal Tables of Contents. Follow the instructions below to access tables of contents. CARL Uncover provides fee based document delivery services for selected journals.

A. Point your browser to:

http://uncweb.carl.org:80/

B. click on "Search Uncover"
C. click on "Search Uncover Now"
D. Type the Journal Name in the search box and click the radio button "Journal Title Browse"
E. click on the journal name
F. click on "journal issues"
G. click on the issues identified below

American Journal of Public Health (Vol. 90, No. 2, February 2000). Note: This journal is available in full text in the EBSCO Host Academic Search Elite Database and the ProQuest Research Library. Check your library for the availability of either of these two databases and of this issue.

Journal of Aging and Physical Activity (Vol. 8, No. 1, January 2000).

The International Journal of Aging and Human Development (Vol. 49, No. 3, 1999).

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V. Funding Opportunities:

14. NIH NIA PROGRAM ANNOUNCEMENTS:

A. Higher-Order Cognitive Functioning and Aging (PA-00-052). "The National Institute on Aging (NIA) invites qualified researchers to submit new applications for research projects that focus on adulthood and aging-related changes in the higher-order processes and strategies required for judgment, decision-making, reasoning, problem-solving, and processing complex information. As in earlier periods of life older adults continue to make decisions related to everyday life, but with advanced age, new, and sometimes even more complex, decision-making is required of them. Recent research indicates that age-related limitations in cognitive processing resources (e.g., speed and working memory) may impact decision-making. Research also indicates that some older adults experience growth in specific areas of cognitive functioning (e.g., expertise, semantic knowledge, emotional regulation) and continue to use adaptive intelligence, demonstrating multi-directionality in adult cognitive change. It is generally recognized that research on higher-order processing is underdeveloped in the field of aging. Research proposals are needed that examine the actual processes that are engaged when older adults make important decisions, how these processes change with age and context, and what environmental supports, interventions, and training may be necessary for optimal functioning. Research may investigate either individual or collaborative, or social processes." More information can be found at:

http://grants.nih.gov/grants/guide/pa-files/PA-00-052.html

B. NIA Pilot Research Grant Program (PA-00-053). "The National Institute on Aging (NIA) is seeking small grant (R03) applications in specific areas to: (1) stimulate and facilitate the entry of promising new investigators into aging research, and (2) encourage established investigators to enter new targeted, high priority areas in this research field. This Small Grant (R03) Program provides support for pilot research that is likely to lead to a subsequent individual research project grant (R01) that is focused on aging and/or a significant advancement of aging research." More information can be found at:

http://grants.nih.gov/grants/guide/pa-files/PA-00-053.html

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VI. Conferences

15. MAX PLANCK INSTITUTE FOR DEMOGRAPHIC RESEARCH WORKSHOP: The MPIDR has announced a workshop in Demographic-Macroeconomic Modelling to be held at the Institute in Rostock, Germany October 11-13, 2000. Applications and abstracts of papers should be sent by July 31, 2000. "The general thrust of the workshop is to bring together a group of people from demography and economics and to present and discuss methodological developments at the interface of formal demography and macroeconomics with a specific focus on the areas of: ageing and age structure effects on economic performance; population growth and economic growth in the long run; and differential demographic changes and repercussions on economic performance." For more information see:

http://www.demogr.mpg.de/Events/Workshops/MacroEconMod.htm
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16. NIA SUMMER INSTITUTE ON AGING RESEARCH: The National Institute on Aging offers a Summer Institute on Aging Research which "offers new researchers intensive exposure to issues and challenges in research on aging. New researchers are defined as those who have received the M.D., Ph.D. or other doctoral level degree, are at the beginning stages of a research career, and demonstrate a capacity or potential for highly productive independent research. The doctoral degree may be in the biological, clinical, behavioral or social sciences." The Summer Institute will be held July 8-14, 2000. More information can be found at:

http://www.nih.gov/nia/new/summer/summer.htm

Note: all documents at the site are in .pdf format.

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VII. Student Opportunities

17. NASI SUMMER INTERNSHIPS AND DISSERTATION AWARD: The National Academy of Social Insurance is offering two Summer internships and a dissertation award. For more information, including application information and deadlines, see:

http://www.nasi.org/Leader/lead.htm

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VIII. Legislation Information Updates

18. AOA OLDER AMERICANS ACT APPROPRIATION UPDATE: This website "update includes the final FY 2000 Appropriation as signed by the President and reflects the 0.38% rescission."

http://www.aoa.gov/Oaa/oaaapp.html
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19. US SENATE SPECIAL COMMITTEE ON AGING COMMITTEE EVENT:

A. The Special Committee on Aging has released testimony from "The Right Medicine? Examining the Breaux-Frist Prescription for Saving Medicare," a hearing held on Feb. 8, 2000.

http://www.senate.gov/~aging/hr43.htm

B. "Medicare: Program Reform and Modernization Are Needed but Entail Considerable Challenges," by David M. Walker, Comptroller General of the United States, before the Senate Special Committee on Aging, Feb. 8, 2000, T-HEHS/AIMD-00-77, .pdf format, 25p.).

http://www.gao.gov/new.items/h100077t.pdf

Note: GAO Internet addresses are valid for only a limited period of time. After that time, documents can be found by searching the Government Printing Office:

http://www.access.gpo.gov/su_docs/aces/aces160.shtml

and searching on title or report number.

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IX. Websites of Interest

20. ACCESSING AMERICA FOR SENIORS WEBSITE ADDITION: The well known Accessing America for Seniors website has recently added a section that
provides the latest news and information from government web sites as it is released.

http://www.seniors.gov/
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21. AGING SOCIETY CHRONIC AND DISBABLING CONDITIONS PROFILES UPDATE: The Aging Society has added a new profile: "At Risk: Developing Chronic Conditions Later in Life," (Challenges for the 21st Century: Chronic and Disabling Conditions No. 4, February 2000, .pdf format, 6p.). Most of the data in this profile are taken from Wave 1 of the Health and Retirement Study (HRS).

http://www.agingsociety.org/risk.pdf

Profiles:

http://www.agingsociety.org/profiles.htm

Jack Solock
Data Librarian--Center for Demography and Ecology
4470 Social Science
University of Wisconsin-Madison
Madison, WI 53706
608-262-9827
jsolock@ssc.wisc.edu