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Medicaid 居家照护者对技能培训的需求

The demand for skills training among Medicaid home-based caregivers
Journal of Health Economics · 2024 · Cronin, Christopher J.、Lieber, Ethan M.J.

中文摘要

Medicaid 每年在残疾人居家与社区照护上的支出近 1000 亿美元。这些照护服务大部分由个人护理助理提供,而其中很少有人接受过与其所提供服务相关的培训。我们开展了一项随机对照试验来估计他们对培训的需求。我们发现,在没有激励的情况下,13% 的照护者完成了培训。向照护者支付相当于其时薪四倍的报酬,可使培训完成率提高约 9 个百分点。额外的实验变异表明,在经确认知晓该培训的个体中,财务激励使完成率从 35% 提高到 58%。基于这些结果的需求曲线表明,尽管许多照护者重视培训机会,但旨在实现普遍参与的政策需要大额财务激励。

Abstract

Medicaid spends nearly 100 billion dollars annually on home and community-based care for the disabled. Much of this care is provided by personal care aides, few of whom have received training related to the services they provide. We conducted a randomized controlled trial to estimate their demand for training. We find that 13 percent of these caregivers complete training without an incentive. Paying the caregivers four times their hourly wage increases training completion by roughly nine percentage points. Additional experimental variation suggests that among individuals confirmed to be aware of the training, the financial incentive increases completion from 35 to 58 percent. Demand curves based on these results suggest that while many caregivers value the opportunity to train, policies aimed at universal take up require large financial incentives.
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