Current Awareness in Aging Research (CAAR) Report #164--December 5, 2002

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:


I. Data:

1. PSID: The University of Michigan Institute for Social Research Panel Study for Income Dynamics has announced two additions to its website as of Nov. 27, 2002:

A. The 2001 Data are now available: Included are the 2001 Individual, Family, Income Plus, Wealth, Work Hours & Wage Rates, Relationship History, and Weight files, based on data collected from 7,406 PSID families and 21,396 individuals between February and December 2001. New data content for 2001 includes: A supplement on Philanthropic Giving; A short screening scale for Psychological Distress (K6). Note that there is no link from this announcement at the time of distribution of this email.

B. The 2001 Income Plus data file is now available: This includes all income components including total family income and components, occupation industry codes, and USDA and Census annual needs standards.



II. Reports and articles:

2. OIG INSPECTION REPORT: "Oversight of Medicare PPS-Exempt Hospital Services" (US Department of Health and Human Services, Office of the Inspector General, OEI-12-02-00170, November 2002, .pdf format, 12p.).


The OIG released a final inspection report on the review of Prospective Payment System (PPS)-exempt inpatient services for reasonableness and medical necessity. At the time of our inspection, we found that routine statistical analysis and medical review of Prospective Payment System (PPS)-exempt inpatient services for medical necessity and reasonableness were not being conducted. Medicare paid approximately $8.7 billion to PPS-exempt hospitals in 2000. The OIG Office of Audit Services report,"Improper Fiscal Year 2000 Medicare Fee-for-Service Payments," attributed $800 million of improper payments to issues of medical necessity in PPS-exempt facilities. Shortly after we exited with CMS regarding this report, the agency released a transmittal notifying fiscal intermediaries that they may include PPS-exempt hospitals in their reviews; however, no additional funding was provided for this expansion of review responsibility. The OIG remains concerned that given the lack of dedicated funding and an explicit level of effort or performance goal, the amount of oversight that will occur remains unclear. Further, to the extent that fiscal intermediaries do review PPS-exempt hospital services, it occurs at the expense of oversight of other Part A providers, such as nursing homes and home health agencies. The OIG recommends that CMS ensure oversight of PPS-exempt hospital services.

3. GAO REPORT: "Medicare+Choice: Selected Program Requirements and Other Entities' Standards for HMOs" (US General Accounting Office GAO 03-180, October 2002, .pdf format, 77p.).

Note: This is a temporary address. GAO reports will be available at:

Search on title or report number.

4. KFF REPORT: "The Current State of Retiree Health Benefits: Findings from the Kaiser/Hewitt 2002 Retiree Health Survey" (Kaiser Family Foundation, December 2002, .pdf format, 67p.). A chartpack (.pdf format, 32p.) and news release (.pdf format, 3p.) are also included. "This report presents findings from a study of large private-sector employers conducted by researchers at Hewitt Associates and the Kaiser Family Foundation between July and September of 2002. The study is based on survey responses of 435 large private-sector firms (1,000+ employees) that currently offer retiree health benefits, and includes 36% of all Fortune 100 companies and 28% of all Fortune 500 companies. Information was collected on a variety of topics including costs, premiums, retiree contributions, benefit design, prescription drug benefits, recent changes and expected changes within next three years, and the implications of a Medicare drug benefit for employers."


A. "$17.5M For Older Australians From Culturally and Linguistically Diverse Backgrounds" (Nov. 28, 2002).

B. "$22M Boost For Home and Community Care in Queensland" (Nov. 27, 2002).

C. "Thousands of New Aged Care Places For Rural and Regional Australia" (Nov. 26, 2002).

6. UK AGE POSITIVE PRESS RELEASE: "MORI Poll shows why the Age Positive campaign is so important," (UK Department of Work and Pensions, Dec. 3, 2002, graphs of findings in PowerPoint format).

More information on UK Age Positive:

See "About us".

7. NIH NEWS RELEASE: "Study Confirms Breast Cancer Risk in Continuous Combined Hormone Therapy Risk Begins to Return to Normal After Women Stop Taking Hormones" (US National Institutes of Health, Nov. 29, 2002).

8. FDA TALK PAPER: "FDA Approves Teriparatide to Treat Osteoporosis" (US Food and Drug Administration Talk Paper T02-49, Nov. 26, 2002).

9. NATURE NEUROSCIENCE ARTICLE ABSTRACT: "Role of CD40 ligand in amyloidosis in transgenic Alzheimer's mice," by J. Tan, T. Town, F. Crawford, T. Mori, A. Delledone, R. Crescentini, D. Obregon, R.A. Flavell, and M.J. Mullan (_Nature Neuroscience_, Vol. 5, No. 12, December 2002, p. 1288-1293).


A. "The Metabolic Syndrome and Total and Cardiovascular Disease Mortality in Middle-aged Men," by Hanna-Maaria Lakka, David E. Laaksonen, Timo A. Lakka, Leo K. Niskanen, Esko Kumpusalo, Jaakko Tuomilehto, and Jukka T. Salonen (_Journal of the American Medical Association_, Vol. 288, No. 21, Dec. 4, 2002, p. 2709-2716).

B. "Withdrawal of Life Support: Intensive Caring at the End of Life," by Thomas J. Prendergast and Kathleen A. Puntillo (_Journal of the American Medical Association_ Clinician's Corner abstract, Vol. 288, No. 21, Dec. 4, 2002, p. 2732-2740).

11. _NEJM_ ARTICLE ABSTRACT: "Abnormality of Gait as a Predictor of Non-Alzheimer's Dementia," by Joe Verghese, Richard B. Lipton, Charles B. Hall, Gail Kuslansky, Mindy J. Katz, and Herman Buschke (_New England Journal of Medicine_, Vol. 347, No. 22, Nov. 28, 2002, p. 1761-1768).

12. MEDSCAPE ARTICLES: Note: Medscape requires free registration before providing articles.

A. "Natural Soy Lowers Blood Pressure in Postmenopausal Women," by Michelle Bridenbaker (Conference News from the 75th Scientific Sessions of the American Heart Association, held Nov. 17-20, 2002, in Chicago, Illinois, via Medscape).

B. "Comparison of Acute Coronary Syndromes Among Elderly African Americans, Elderly Whites, and Elderly Patients of Other Races," by Devraj Nayak, Stephen Woodworth, Wilbert S. Aronow, Anthony L. Pucillo, and Srinivas Koneru (_Heart Disease: A journal of cardiovascular medicine_, Vol. 4, No. 5, 2002, p. 282-284, via Medscape).

13. _TIME_ SPECIAL SECTION: "The Coming Epidemic of Arthritis" (_Time_ Vol. 160, No. 24, Dec. 9, 2002). There are three articles on the topic.

14. _NEWSWEEK_ ARTICLE: "Pension Funds Risky Business: Many companies that still have traditional pension funds will likely do what comes naturally, and transfer risk to their employees," by Allan Sloan (_Newsweek_, Dec. 9, 2002).


III. Working Papers:

15. NBER: "Pharmaceutical-embodied technical progress, longevity, and quality of life: drugs as 'equipment for your health'," by Frank R. Lichtenberg and Suchin Virabhak (National Bureau of Economic Research w9351, November 2002, .pdf format, 44p.).


Several econometric studies have concluded that technical progress embodied in equipment is a major source of manufacturing productivity growth. Other research has suggested that, over the long run, growth in the U.S. economy's 'health output' has been at least as large as the growth in non-health goods and services. One important input in the production of health pharmaceuticals is even more R&D- intensive than equipment. In this paper we test the pharmaceutical-embodied technical progress hypothesis [--] the hypothesis that newer drugs increase the length and quality of life and estimate the rate of progress. To do this, we estimate health production functions, in which the dependent variables are various indicators of post-treatment health status (such as survival, perceived health status, and presence of physical or cognitive limitations), and the regressors include drug vintage (the year in which the FDA first approved a drug's active ingredient(s)) and indicators of pre-treatment health status. We estimate these relationships using extremely disaggregated prescription- level cross-sectional data derived primarily from the 1997 Medical Expenditure Panel Survey. We find that people who used newer drugs had better post-treatment health than people using older drugs for the same condition, controlling for pre-treatment health, age, sex, race, marital status, education, income, and insurance coverage: they were more likely to survive, their perceived health status was higher, and they experienced fewer activity, social, and physical limitations. The estimated cost of the increase in vintage required to keep a person alive is lower than some estimates of the value of remaining alive for one month. One estimate of the cost of preventing an activity limitation is $1745, and the annual rate of technical progress with respect to activity limitations is 8.4%. People consuming newer drugs tend to experience greater increases (or smaller declines) in physical ability than people consuming older drugs. Most of the health measures indicate that the effect of drug vintage on health is higher for people with low initial health than it is for people with high initial health. Therefore in contrast to equipment-embodied technical progress, which tends to increase economic inequality, pharmaceutical-embodied technical progress has a tendency to reduce inequality as well as promote economic growth, broadly defined.

Click on "PDF" or submit your email address at the bottom of the abstract for full text.

16. UNIVERSITY OF MICHIGAN POPULATION STUDIES CENTER: "Gender and Intergenerational Exchange in Vietnam," by Jed Friedman, John Knodel, Bui The Cuong, and Truong Si Anh (PSC Research Report 02-529, November 2002, .pdf format, 21p.).


Although both women and the elderly are assumed to be disadvantaged in much of the world, systematic empirically based studies of interactions between gender and aging are rare. We examine the gender dimensions of elderly support and economic well-being in Vietnam based on data from the 1999 3% census sample and two regional surveys of the elderly conducted in 1996 and 1997. The study incorporates both descriptive and multivariate analysis of sources of support including work, non-familial support, and especially familial support through intergenerational exchange, the most import source for most elderly Vietnamese. We consider the gender of both the recipient and provider of support. Vietnam provides a particularly interesting context for the study given substantial regional cultural differences in the extent of the patriarchal/patrilineal family systems. These differences are most readily apparent in the wide regional variation in preferences of elderly to reside with married sons rather than married daughters. The receipt of intergenerational transfers, the most important form of elderly support in Vietnam, shows little significant variation across gender once the mediating effect of marital status differences is taken into account. In addition, gender differences in economic well-being, as measured by an index of household wealth and through self-perceptions of economic satisfaction, are very modest once other factors, most notably marital status and age, that are correlated both with gender and the receipt of familial and non-familial support are taken into account.


A. "Forecasting Incidence of Work Limitations, Disability Insurance Receipt, and Mortality in Dynamic Simulation Models Using Social Security Administrative Records: A Research Note," by Melissa Favreault (WP 2002-09, December 2002, .pdf format, 22p.). Links to a detailed abstract, as well as full text, can be found at:

Click on "here" for full text.

B. "Job Search Behavior at the End of the Life Cycle," by Hugo Benitez-Silva (WP 2002-10, December 2002, .pdf format, 38p.).

This paper presents one of the first formal dynamic models of job search by older individuals. It also presents an empirical analysis of job search behavior among this population using the Health and Retirement Study. Several factors currently compound to make the topic of this research an important one in the agenda of the Economics of Aging: ongoing demographic, epidemiological, socio-economic, technological, and labor market trends indicate that older Americans are more likely to be labor force participants beyond traditional retirement ages. Increasing longevity, improving health, strong labor market conditions, increasing labor supply flexibility stemming from an increase in part-time work and self-employment and the use of technological advances to promote second careers, and increasing labor force participation, make the study of search behavior at the end of the life cycle, in a formal theoretical and empirical model, an important contribution. Our findings show that older Americans actively search for new jobs, both on the job and when out of work, and that previous work attachment and health limitations are key to understanding the different job search behavior of employed and non-employed individuals, as well as males and females.

Click on "here" for full text.


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

18. Age an Ageing (Vol. 31, No. 6, November 2002). Note: Full electronic text (.pdf format) may be available at the site. Check your organization's library.

19. Journal of Health Economics (Vol. 21, No. 6, November 2002). Note: Full electronic text (.pdf format) may be available at the site. Check your organization's library.

Click on "ScienceDirect Abstracts & Full Text".

20. INGENTA Tables of Contents: INGENTA provides fee based document delivery services for selected journals.

A. Point your browser to:

B. click on "Search Options"
C. Type the Journal Name in the "Publication title" search box and click the radio button "Words in Title"
D. View the table of contents for the issue noted.

American Sociological Review (Vol. 67, No. 5, 2002). Note: Full electronic text of this journal is available in the ProQuest Research Library. Check your library for availability of this database and this issue.

Journal of the American Geriatrics Society (Vol. 50, No. 11, 2002).

Journal of Health and Social Behavior (Vol. 43, No. 3, 2002). Note: Full electronic text of this journal is available in the ProQuest Research Library. Check your library for availability of this database and this issue.

21. AMEDEO MEDICAL LITERATURE: Note: "AMEDEO has been created to serve the needs of healthcare professionals, including physicians, nurses, pharmacists, administrators, other members of the health professions, and patients and their friends. They can easily access timely, relevant information within their respective fields... All AMEDEO services are free of charge. This policy was made possible thanks to generous unrestricted educational grants provided by AMGEN, Berlex, Eisai, Glaxo Wellcome, Novartis, Pfizer, Roche, and Schering AG."

A. Osteoporosis: Literature for the week of Dec. 3, 2002:

B. Alzheimer's Disease: Literature for the week of Dec. 3, 2002:

C. Parkinson's Disease: Literature for the week of Dec. 3, 2002:

AMADEO Literature Guide:

Jack Solock
Data Librarian--Center for Demography and Ecology and Center for
Demography of Health and Aging
4470 Social Science
University of Wisconsin-Madison
Madison, WI 53706