Current Awareness in Aging Research (CAAR) Report #171--January 30, 2003


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. NCHS:

A. "Large MSA Identification for 1997-2001 National Health Interview Surveys" (US National Center for Health Statistics, ASCII text format)."[These] files describe the data files, ASCII files that contain one record for every household in the [corresponding] National Health Interview Survey (NHIS) that is in a Metropolitan Statistical Area (MSA) which has at least 1,000,000 population. Where applicable, an identity of a Consolidated Metropolitan Statistical Area (CMSA) has also been provided. Records are included for NHIS responding and non-responding households.






B. NCHS NHANES DATA BRIEF: "Use of Hormone Replacement Therapy Among Postmenopausal Women, 1988-94" (US National Center for Health Statistics, National Health and Nutrition Examination Survey Data Brief, January 2003, .pdf format, 2p.).


II. Reports and articles:

2. KFF REPORT: "Paying for Choice: The Cost Implications of Health Plan Options For People on Medicare," by Rani E. Snyder, Thomas Rice, and Michelle Kitchman (Kaiser Family Foundation, January 2003, .pdf format, 59p.).


This report illustrates the financial stakes for Medicare beneficiaries when making choices about supplemental insurance coverage, by examining how much people on Medicare could spend out-of-pocket including premiums and other cost-sharing requirements under different supplemental insurance options. To assess the cost implications of choosing between different Medigap and Medicare+Choice insurance options, the research team estimated the range in health care expenditures associated with three prototypical beneficiaries (a 50 year-old man with disabilities, a relatively healthy 65 year-old woman, and a frail 80 year-old woman) within and across eight distinct geographic areas. Cost comparison included four standardized Medigap plans (A, F, H, and J) and any of up to five Medicare+Choice HMO options available in each geographic area all in comparison with choosing no supplemental coverage at all.

Click on "Report" at the bottom of the abstract for full text.

3. DHHS NEWS RELEASE: "President to Propose $13 Million Increase to Improve Americans' Access to Generic Drugs" (US Department of Health and Human Services, Jan. 24, 2003).


A. "Improper Fiscal Year 2002 Medicare Fee-for-Service Payments" (US Department of Health and Human Services, Office of the Inspector General, Audit Report A-17-02-02202, January 2003, .pdf format, 18p.).


This final report presents the results of our review of fiscal year (FY) 2002 Medicare fee-for-service claims. The objective of this review was to estimate the extent of fee-for-service payments that did not comply with Medicare laws and regulations. This is the seventh year that the Office of Inspector General (OIG) has estimated these improper payments. As part of our analysis, we have profiled the last 7 years results and identified specific trends where appropriate. Based on our statistical sample, we estimate that improper Medicare benefit payments made during FY 2002 totaled $13.3 billion, or about 6.3 percent of the $212.7 billion in processed fee-for-service payments reported by the Centers for Medicare and Medicaid Services (CMS). These improper payments, as in past years, could range from reimbursement for services provided but inadequately documented to inadvertent mistakes to outright fraud and abuse. The FY 2002 estimate of improper payments is significantly less than the $23.2 billion that we first estimated for FY 1996. As a rate of error, the current 6.3-percent estimate is the same as last year's rate--which was the lowest to date--and less than half of the 13.8 percent reported for FY 1996. Since we developed the first error rate for FY 1996, CMS has demonstrated continued vigilance in monitoring the error rate and developing appropriate corrective action plans. For example, CMS has worked with provider groups, such as the American Medical Association and the American Hospital Association, to clarify reimbursement rules and to impress upon health care providers the importance of fully documenting services. Such efforts have contributed to the large reduction in the rate. In addition, due to efforts by CMS and the provider community, the overwhelming majority of health care providers follow Medicare reimbursement rules and bill correctly. In this regard, since FY 1998, over 92 percent of Medicare fee-for-service payments have contained no errors. Lastly, fraud and abuse initiatives on the part of CMS, the Congress, the Department of Justice (DOJ), and OIG have had a significant impact. However, continued vigilance is needed to ensure that providers maintain adequate documentation supporting billed services, bill only for services that are medically necessary, and properly code claims.

Related press release from DHHS: "Medicare Improper Payments Rate Remains Stable as HHS Moves to New Phase of Payment Measurement" (Jan. 24, 2003).

B. "Quality Assurance Committees in Nursing Homes" (US Department of Health and Human Services, Office of the Inspector General, OEI-01-01-00090, January 2003,.pdf format, 15p.).


The OIG issued a final inspection report that describes the role of quality assessment and assurance committees (QA committees) in nursing homes. The report is significant because QA committees provide a key point of accountability for ensuring both quality of care and quality of life in nursing homes. The OIG's assessment shows that nearly all nursing homes meet CMS' requirements for QA committee membership and frequency of meetings. Furthermore, QA committees have an array of data sources to help target problem areas in their nursing homes. However, a lack of knowledge on conducting QA committee work, as well as staff shortages and turnover, challenge QA committees.

5. GAO REPORT: "Older Workers: Employment Assistance Focuses on Subsidized Jobs and Job Search, but Revised Performance Measures Could Improve Access to Other Services" (US General Accounting Office GAO-03-350, January 2003, .pdf format, 42p.).

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

Search on title or report number.

6. NIH ADEAR PUBLICATION UPDATE: The US National Institutes of Health Alzheimer's Disease Education and Referral Center (ADEAR) has updated its online publication "Alzheimer's Disease: Unraveling the Mystery" (HTML and .pdf format, 60p.). Print copies along with an accompanying CD-ROM are available free of charge from ADEAR at 1-800-438-4380, or via email request to

7. UK OFFICE OF NATIONAL STATISTICS REPORT: The Office of National Statistics has issued "Social Trends 33" (January 2003), which offers a variety of statistics about the UK. The complete report is not available on line, but access to individual tables from the report are available in Excel and comma-delimited format. Some of the tables include:

"Distribution of income for pensioners by family type and pension scheme"

"Pension provision: by selected employment status, sex and age, 2000/01"

"Types of help given by informal carers, 2000/01"

"Places available in residential care homes: by sector"

The executive summary can be found at:

8. _SCIENCE_ ARTICLE ABSTRACT: "Extended Longevity in Mice Lacking the Insulin Receptor in Adipose Tissue," by Matthias Bluher, Barbara B. Kahn, and C. Ronald Kahn (_Science_ Vol. 299, No. 5606, Jan. 24, 2002, p. 572-574).


A. "Older women less likely to receive chemotherapy for breast cancer," by Janice Hopkins Tanne (_British Medical Journal_ News Extra, Vol. 326 No. 184, Jan. 25, 2003, p. 184).

B. "Changing prescription software to favour generics could save Australia 40m Pounds a year," by Bob Burton (_British Medical Journal_ News Extra, Vol. 326 No. 184, Jan. 25, 2003, p. 184).

C. _Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia_, by David Clark and Michael Wright, reviewed by Zbigniew Zylicz (_British Medical Journal_ Book Review, Vol. 326 No. 184, Jan. 25, 2003, HTML and .pdf format, p. 228).

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

A. "Racial and Age-Related Disparities in Obtaining Screening Mammography: Results of a Statewide Database," by Abdul Rahman Jazieh and Charles R. Buncher (_Southern Medical Journal_, Vol. 95, No. 10, 2002, p. 1145-1148, via Medscape).

B. "Implications of Amyloid Precursor Protein and Subsequent Beta-Amyloid Production to the Pharmacotherapy of Alzheimer's Disease," by Carlos H. Rojas-Fernandez, Ming Chen, and Hugo L. Fernandez (_Pharmacotherapy_, Vol. 22, No. 12, 2002, p. 1547-1563, via Medscape).


III. Working Papers:

11. PENNSYLVANIA INSTITUTE FOR ECONOMIC RESEARCH (PIER) [University of Pennsylvania]: "Consumption over the Life Cycle: Some Facts from Consumer Expenditure Survey Data," by Jesus Fernandez-Villaverde and Dirk Krueger (Working Paper 02-44, November 2002, .pdf format, 60p.).


This paper uses a semi-nonparametric model and Consumer Expenditure Survey data to estimate life cycle profiles of consumption, controlling for demographics, cohort and time effects. In addition to documenting profiles for total and nondurable consumption, we devote special attention to the age expenditure pattern for consumer durables. We find hump-shaped paths over the life cycle for total, for nondurable and for durable expenditures. Changes in household size account for roughly half of these humps. The other half remains unaccounted for by the standard complete markets life cycle model. Our results imply that households do not smooth consumption over their lifetimes. This is especially true for services from consumer durables. Bootstrap simulations suggest that our empirical estimates are tight and sensitivity analysis indicates that the computed profiles are robust to a large number of different specifications.

More information on PIER:

12. BOSTON COLLEGE CENTER FOR RETIREMENT RESEARCH: "The Role of Marital History, Early Retirement Benefits, and the Economic Status of Women," by Tay K. McNamara, Regina O'Grady-LeShane, and John B. Williamson (Working Paper 2003-01, January 2003, .pdf format, 28p.).


This article compares the relative economic status of women who take and postpone taking early Social Security benefits, with particular attention to the role of marital history. Marital history categories discussed include: lifelong marriages, marriages in which the woman had been previously divorced or widowed, divorced, widowed, and never married. The results presented here should be useful in evaluating the potential consequences of increasing the Earliest Entitlement Age (EEA). While increasing the EEA would not cause economic hardship for many, it may have adverse effects on divorced and widowed women who generally are at greater risk of poverty than married women. The economic effects of prior divorce or widowhood are reflected in the lower financial resources of women who remarry.

Click on "here" for full text.

13. FEDERAL RESERVE BANK OF MINNEAPOLIS: "Wealth Inequality and Intergenerational Links," by Mariacristina De Nardi (Federal Reserve Bank of Minneapolis Staff Paper 314, November 2002, .pdf and PostScript format, 43p.).


Previous work has had difficulty generating household saving behavior that makes the distribution of wealth much more concentrated than that of labor earnings, and that makes the richest households hold onto large amounts of wealth, even during very old age. I construct a quantitative, general equilibrium, overlapping-generations model in which parents and children are linked by accidental and voluntary bequests and by earnings ability. I show that voluntary bequests can explain the emergence of large estates, while accidental bequests alone cannot, and that adding earnings persistence within families increases wealth concentration even more. I also show that the introduction of a bequest motive generates lifetime savings profiles more consistent with the data.

Click on "Adobe Acrobat (.pdf) version" or "PostScript (.ps) version" for full text.


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

14. Experimental Aging Research (Vol. 29, No. 1, Jan-Mar 2003). Note: Full electronic text is available in the EBSCO Host Academic Search Elite Database. Check your library for the availability of this database and this issue.

Under "Quick Search" type "Experimental Aging Research" (without the quotes), Using "Exact Phrase", Return "Publications". Then click on Volume 29, Number 1/January-March 2003.

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

A. Point your browser to:

B. click on "browse by publication"
C. Type the Journal Name in the "by words in the title" search box and click "search".
D. View the table of contents for the issue noted.

American Journal of Public Health (Vol. 93, No. 2, 2003). Note: Full electronic text is available in the EBSCO Host Academic Search Elite Database and the ProQuest Research Library. Check your library for the availability of these databases and this issue.

Educational Gerontology (Vol. 29, No. 1, 2003). Note: Full electronic text is available in the EBSCO Host Academic Search Elite Database. Check your library for the availability of this database and this issue.

Research on Aging (Vol. 25, No. 1, 2003). Note: Full electronic text is available in the EBSCO Host Academic Search Elite Database and the ProQuest Research Library. Check your library for the availability of these databases and this issue.

16. 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 Jan. 28, 2003:

B. Alzheimer's Disease: Literature for the week of Jan. 28, 2003:

C. Parkinson's Disease: Literature for the week of Jan. 28, 2003:

AMADEO Literature Guide:


V. Funding Opportunities/Internship Opportunities:

17. NIH:

A. "Epidemiology of Alcohol Consumption and Alcohol-Related Problems in Older Persons" (US National Institutes of Health, National Institute on Aging, in conjunction with the National Institute on Alcohol Abuse and Alcoholism, PA-03-061, Jan. 22, 2003). For more information see:

B. "Addendum to Brain Disorders in the Developing World: Research Across the Lifespan" (US National Institutes of Health, National Institute on Aging, in conjunction with several other agencies, NOT-TW-03-005, Jan. 22, 2003). For more information see:

18. NASI INTERNSHIP OPPORTUNITIES: The National Academy of Social Insurance (NASI) has announced the availability of two 12 week summer internships for graduate and upper level undergraduate students. For more information on the Washington Internship on Social Insurance and the Somers Aging and Long-Term Care Research Internship, including application information, see:

More information on NASI:

Click on "About the Academy."


VI. Conferences:

19. AOA TOWN HALL LISTENING SESSIONS: "A Caring America: Choices for Independence." The US Administration on Aging is conducting a series of local Town Hall Listening Sessions in 2003 to hear from older people, their families and caregivers, along with members of the Aging Services Network" on several issues. For more information see:


VII. Legislation Information Updates:


A. "The Image of Aging in Media and Marketing," a hearing held Sep. 4, 2002 (US Senate Hearing 107-797, Senate Serial Publication No. 107-35, ASCII text and .pdf format, 81p.).

Scroll to or "find in page" "107-797" (without the quotes).

B. The following publications are available (print only) via the Senate Special Committee on Aging. Publications may be ordered free of charge, and ordering information is available at the site.

107-25 Schemer, Scammers, and Sweetheart Deals: Financial Predators of the Elderly

107-26 Settling for Silver in the Golden Years: The Special Challenges of Women in Retirement Planning and Security

107-27 Long-Term Care Financing: Blueprints for Reform

107-28 High-Tech Medicine: Reaching Out to Seniors Through Technology

107-29 Buyer Beware: Public Health Concerns of Counterfeit Medicine

107-30 Identity Theft: The Nation's Fastest Growing Crime Wave Hits Seniors

107-31 Retirement Security and Corporate Responsibility

107-32 Healthy Aging and Nutrition: The Science of Living Longer

107-33 Expanding and Improving Medicare: Prescription Drugs: An Oregon Perspective

107-34 Planning For Retirement: Promoting Security and Dignity of American Retirement

107-35 The Image of Aging in Media and Marketing (also available above via the Government Printing Office)

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