Current Awareness in Aging Research (CAAR) Report #50--September 14, 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:


I. Data:


A. The University of Michigan Institute for Social Research Health and Retirement Study (HRS) / Asset and Health Dynamics Among the Oldest Old (AHEAD) website has released a solicitation for "New Modules for HRS 2002." More information, including a timetable for module developments can be found at:

B. The site has also added information on HRS 2000 modules.

Click on "HRS 2000 Modules."

2. NCHS: "International Classification of Diseases 9th Revision Clinical Modification 2000 (ICD-9-CM)." These files "include the entire text of "The International Classification of Diseases, 9th Revision, Clinical Modification" (ICD-9-CM), Sixth Edition, issued for use beginning October 1, 2000 for federal fiscal year 2001 (FY01). The ICD-9-CM is maintained jointly by the National Center for Health Statistics (NCHS) and the Health Care Financing Agency (HCFA). These files are in Rich Text Format and may be imported into most word processors with indentation intact. These files come from the official version of the ICD-9-CM, which is available on CD-ROM from the U.S. Government Printing Office, (202) 512-1800, order number 017-022-01499-8. This CD-ROM includes Folio Corporation's VIEWS (tm) software, which features keyword searching and hypertext linking.


II. Reports and articles:

3. _DEMOGRAPHIC RESEARCH_ ARTICLE: "Measuring the Compression of Mortality," by Vaino Kannisto (_Demographic Research_, Vol. 3, No. 6, September 2000, HTML and .pdf formats, 24p.). Note: _Demographic Research_ is "a free, expedited, peer-reviewed journal of the population sciences...published by the Max Planck Institute for Demographic Research, Rostock Germany."


Compression of mortality is measured here in four ways: (1) by standard deviation of the age at death above the mode; (2) by standard deviation of the age at death in the highest quartile; (3) by the inter-quartile range; and (4) by the shortest age interval in which a given proportion of deaths take place. The two first-mentioned are directed at old ages while the other two measure compression over the entire age range. The fourth alternative is recommended as the most suitable for general use and offers several variations, called the C-family of compression indicators. Applied to historical and modern populations, all four measures show convincingly that the secular transition from high to low mortality has been accompanied by general and massive compression of mortality. In recent decades, however, this development has come close to stagnation even when life expectancy continues to increase. This has happened at a level where compression is still so incomplete that the shortest age interval in which 90 percent of deaths occur, is more than 35 years. It seems unrealistic to expect human mortality ever to be compressed into so narrow an age interval that the survival curve would be even approximately rectangular. It is considered useful to monitor changes in the compression of mortality because the indicators describe relevant aspects of the length of life and may acquire new significance as indicators of population heterogeneity.

Click on PDF icon at the bottom of the abstract for .pdf version.


A. "Medicare Beneficiary Access to Skilled Nursing Facilities: 2000" (Department of Health and Human Services Office of Evaluations and Inpections; Office of the Inspector General OEI-02-00-00330, September 2000, .pdf format, 23p.).

Abstract:This inspection looks at Medicare beneficiary access to skilled nursing facilities under the Medicare prospective payment system. It is based on a survey of 202 hospital discharge planners and an analysis of Medicare claims data. We found that almost all discharge planners can place all of their Medicare beneficiaries in SNFs [Skilled Nursing Facilities]. Medicare data showing a rise in the number of Medicare beds available support the response of discharge planners that there are adequate skilled nursing home beds available. While some Medicare beneficiaries do experience delays before they are placed in a SNF, Medicare data show a slight decrease in hospital lengths of stay before discharge to a SNF.

B. "Medicare Home Health Agency Survey and Certification Deficiencies" (Department of Health and Human Services Office of Evaluations and Inpections; Office of the Inspector General OEI-02-99-00532, September 2000, .pdf format, 26p.).


This OIG inspection found that overall, home health agency survey and certification deficiencies have increased (26 percent between the first 6 months of 1997 and 1999), but there is no single explanation for this growth. Reasons that may account for this increase include changes in the survey schedule, increased Federal involvement, declining quality of care, and the interim payment system. We concluded that just as there is no single cause for the increase in home health agency deficiencies, there is no single course of action to be taken. Instead, a combination of approaches may be appropriate, including strengthened State survey protocols and continued close scrutiny of the care being provided. The upcoming prospective payment system will also address this problem.

C. "Adequacy of Home Health Services: Hospital Re-Admissions and Emergency Room Visits" (Department of Health and Human Services Office of Evaluations and Inpections; Office of the Inspector General OEI-02-99-00531, September 2000, .pdf format, 25p.).


This inspection looked at hospital re-admissions and emergency room visits for patients discharged from the hospital to home health care. Our inspection did not find any significant increases in re-admission or emergency room visit rates since the implementation of the interim payment system. In fact, they decreased. This was true in general and also for high volume diagnoses and diagnoses identified as at-risk.

D. "Medicare Beneficiary Access to Home Health Agencies: 2000 (Department of Health and Human Services Office of Evaluations and Inpections; Office of the Inspector General OEI-02-00-00320, September 2000, .pdf format, 24p.).


This inspection describes the effects of the interim payment system on access to home health agencies for Medicare beneficiaries discharged from the hospital. The findings of this follow-up study are consistent with those in our 1999 study, "Medicare Beneficiary Access to Home Health Agencies." Almost all Medicare beneficiaries can be placed with home health. In fact, 88 percent of discharge planners report that they place all eligible Medicare patients in home health, while some patients experience delays. Most discharge planners report that delays are not more common now than before IPS [Interim Payment System]. We concluded that there appears to be no widespread problem with placing Medicare hospital patients with home health agencies.

5. HCFA PROGRAM MEMORANDUM: "New List of Drugs, Biologics, Devices, and New Technology Services for the Outpatient Prospective Payment System," effective October 1, 2000 (Microsoft Word and .pdf formats, 16p.). "The purpose of this Program Memorandum (PM) is to provide hospitals a list of long descriptors for drugs, biologicals, and devices eligible for transitional pass through payments, and for items classified in "new technology" ambulatory payment classifications (APCs) under the Outpatient PPS [Prospective Payment System]."

Scroll to "New List of Drugs, Biologics, Devices..."


A. "Catalog of University Presentations, 2000-2001" (National Center for Health Statistics, September 2000, .pdf format, 34p.).

B. "International Health Data Reference Guide, 1999," (National Center for Health Statistics, .pdf format, 161p.). Note: This guide provides information on the availability of data, not the data itself.

C. "National Hospital Discharge Survey: Annual Summary, 1998," by J.R. Popovic and L.J. Kozak (National Center for Health Statistics Series Report 13, No. 148, September 2000, .pdf format, 203p.).

7. _NEJM_ SOUNDING BOARD: "Protecting Research Subjects -- What Must Be Done," by Donna Shalala (_New England Journal of Medicine_ Sounding Board, Vol. 343, No. 11, Sep. 14, 2000, HTML format).

8. _JAMA_ ARTICLE: "Relationship of Hospital Teaching Status With Quality of Care and Mortality for Medicare Patients With Acute MI," by Jeroan J. Allison, Catarina I. Kiefe, Norman W. Weissman, Sharina D. Person, Matthew Rousculp, John G. Canto, Sejong Bae, O. Dale Williams, Robert Farmer, and Robert M. Centor (_Journal of the American Medical Association_, Vol. 284, No. 10, Sep. 13, 2000, p. 1256-1262 HTML and .pdf formats).

9. _THE LANCET_ ARTICLE ABSTRACT: "A palliative-care intervention and death at home: a cluster randomised trial," by Marit S. Jordhoy, Peter Fayers, Turi Saltnes, Marianne Ahlner-Elmqvist, Magnus Jannert, and Stein Kaasa (_The Lancet_, Vol. 356, No. 9233, Sep. 9, 2000, p. 888-893). Note 1: Electronic full text of _Lancet_ articles is available only to subscribers. Note 2: _The Lancet_ requires free registration before providing content of any kind.

10. _TIME_ ARTICLES: The Sep. 18, 2000 issue of _Time_ contains several articles pertinent to issues related to aging. They are:

"A Kinder, Gentler Death," by John Cloud.,3266,54410,00.html

Links to the following stories can be found on the right border of the above story:

"A Call To Action," by Barrett Seaman;
"The High Cost of Dying," by Greg Fulton;
"A Doctor's Journey To The Other Side, by Megan Rutherford;
"Surrounded by Her Family," by Maggie Sieger;
"The Devoted Son," by Dan Cray.

11. _US NEWS AND WORLD REPORT_ ARTICLE: "Sweet charity could be a pretty bitter pill: Will voters swallow prescription drug plans?" by Jodie T. Allen (_US News and World Report_, Sep. 18, 2000).


III. Working Papers:

12. NBER: "Live Long, Live Well: Quantifying the Health of Heterogenous Populations," by John Mullahy (National Bureau of Economic Research Working Paper W7895, September 2000, .pdf format, 52p.).


Various health-, quality-, and disability-adjusted life year or life expectancy (HALY, QALY, DALY; HALE, QALE, DALE) measures have become gold standards for defining outcomes in technology evaluation, population health monitoring, and other evaluative efforts. As such, it is critical that the analytical framework within which these measures are used for descriptive and evaluative purposes be theoretically consistent and statistically rigorous. For instance, widely-accepted definitions of cost-effectiveness ratios and other technology evaluation criteria that are based on expectations of the respective cost and outcome measures must as such be defined in terms of expected HALYs or QALYs. Similarly, measures like HALEs or QALEs used for population health monitoring are typically concerned with population expectations of such measures (or their corresponding totals). This paper demonstrates that estimation of such expectations necessarily requires consideration of the population variation in and covariation between quality and longevity. From the perspective of several different environments characterizing such heterogeneity, quantification or estimation of measures like QUALs are reconsidered. An empirical example of the central issues is provided by means of an analysis of the Years of Healthy Life (YHL) measure drawn from the U.S. National Health Interview Survey.

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

13. SSA ORES: "Early Retirees Under Social Security: Health Status and Economic Resources," by Michael V. Leonesio, Denton R. Vaughan, and Bernard Wixon (Division of Economic Research, Office of Research, Evaluation and Statistics, Office of Policy, Social Security Administration, Working Paper Number 86, August 2000, .pdf format, 44p.).

Abstract Excerpt:

Some proposals to change the Social Security program to ensure long-run solvency would reduce or eliminate benefits to some early retirees. To what extent might those benefit reductions cause hardship for individuals with precarious financial circumstances and whose health appears to limit their ability to offset reductions in Social Security income through increased earnings? Our research is intended to identify the size and characteristics of the population that might be at risk as a consequence of such changes.

14. IIASA: "A Social Security Forecasting and Simulation Model," by F.L. MacKellar, T.Y. Ermolieva and A. Westlund (International Institute for Applied Systems Analysis [Austria] Interim Report IR-00-055, September 2000, .pdf and PostScript formats, 57p.).


This paper presents and validates a multiregional neoclassical economic-demographic growth model developed by the IIASA Social Security Reform Project. This model is intended to study linkages between population age distribution, the macroeconomy, the nature of pension arrangements, the intergenerational distribution of income and wealth, and international capital flows. In this paper, we concentrate on the model in single-region form, showing that: 1. reasonable exogenous assumptions give rise to a reasonable long-run model solution; 2. when exogenous assumptions or model parameters are changed, the model performs sensibly on a baseline-vs.-alternative basis; and 3. model projection results are reasonably robust to selection of demographic scenario and exogenous assumptions regarding household saving and labor supply; they are sensitive, however, to the selection of the parameters of the core production function.

Click on either PDF or PS icons for full text in .pdf or PostScript.


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

15. Aging and Mental Health (Vol. 4, No. 3, August 2000).

16. Archives of Gerontology and Geriatrics (Vol. 31, No. 1, August 2000).

Click on "Tables of Contents and Abstracts"

17. Journal of Health Economics (Vol. 19, No. 5, September 2000). Note: Full electronic text (.pdf format) of this journal is available at this time.

Click on "Tables of Contents" and then "Volume 19, Issue 5, 01-September-2000."

18. Journal of Mental Health and Aging (Vol. 6, No. 3, Fall 2000).

The new Table of Contents is near the bottom of the page.

19. 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:

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 Epidemiology (Vol. 152, No. 5, Sep. 1, 2000).

American Journal of Sociology (Vol. 106, No. 1, July 2000). Note: This journal is available in electronic full-text in the ProQuest Research Library. Check your library for the availability of this database and this issue.

Omega: Journal of Death and Dying (Vol. 40, No. 3, 1999).

Research on Aging (Vol. 22, No. 5, September 2000). Note: This journal is available in electronic full-text in the ProQuest Research Library and the EBSCO Academic Search Elite Database. Check your library for the availability of these databases and this issue.

V. Books:

20. NBER: _Coping with the Pension Crisis -- Where Does Europe Stand?_, Martin Feldstein and Horst Siebert, Editors (National Bureau of Economic Research Forthcoming book of papers from a conference held March 20-21, 2000. The following chapter has been added to this collection:

"Labor Mobility, Redistribution and Pensions Reform in Europe" by Alain Jousten and Pierre Pestieau (.pdf format, 16p.).


In this paper, we discuss the main characteristics of European mandatory pension systems and the implications for these systems of increasing factor mobility. In particular, we expect the extent of redistribution (both intra- and intergenerational) in national pension systems to decrease. The latter result should hold true even in the presence of mobility limited to some particular subgroups in the working population. The present paper explores this issue by considering three types of mobility: not only mobility at the beginning of the working life, but also mobility during the working career and mobility at retirement.

Scroll to "Labor Mobility, Redistribution and Pensions Reform in Europe."

21. _Administrative Aspects of Investment-Based Social Security Reform_, John B. Shoven, editor (224p. NBER-C 2000, University of Chicago Press, Cloth $38.00 ISBN 0-226-75485-5). For more information see:


VI. Funding Opportunities:

22. BOSTON COLLEGE CENTER FOR RETIREMENT RESEARCH: Steven H. Sandell Grant Program. "The Center is currently soliciting proposals for its Sandell Grant Program. The next submission deadline is November 17, 2000 with awards to be announced in January 2001.... The program's purpose is to promote research on retirement issues by junior scholars in a wide variety of disciplines, including actuarial science, demography, economics, finance, gerontology, political science, psychology, public administration, public policy, sociology, social work, and statistics. The program is funded through a grant from the Social Security Administration (SSA). Each grant awarded will be up to $25,000. In addition to submitting a paper, successful applicants will also present their results to SSA in Washington, DC." For more information see:


VII. Legislation Information Updates:

23. SENATE SPECIAL COMMITTEE ON AGING: "Long-Term Care Insurance: Protecting Consumers from Hidden Rate Hikes," a hearing held Sep. 13, 2000 (HTML or .pdf format).

Hearing Testimony:


VIII. Websites of Interest:


The Academy has added a new publication to its "Chronic and Disabling Conditions Data Profiles" page. Report #11 is titled "Alzheimer's Disease and Dementia" (.pdf format, 6p.). Much of the data in the report is taken from the 1994 National Health Interview Survey on Disability, Phase I (NHIS-D) and Wave 1 of the Asset and Health Dynamics of the Oldest Old (AHEAD).

Chronic and Disabling Conditions.

25. SSA HISTORY ARCHIVES CATALOG OF HOLDINGS: The Social Security Administration has released its History Archives holdings catalog of "original source documents, secondary materials, published and unpublished documents, photographs, recordings and artifacts. The Archives contain approximately 1,000 linear feet of documents, about 10,000 photographs, over 200 videotapes and about 500 audio recordings. The material covers the programmatic, legislative and administrative histories of Social Security and Medicare and the history of the Social Security Administration."

26: INTERNET INFORMATION NOTES ADDITION: The Administration on Aging National Aging Information Center has added a new section to its Internet Information Notes metasite (discussed in CAAR #1, Sep. 16, 1999

item #16).

Publishers of Aging-related Journals and Magazines:

Internet Information Notes:

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