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认知局限与荷兰长期照护使用:来自Lifelines队列研究的证据

Cognitive Limitations and Long-Term Care Use in the Netherlands: Evidence from the Lifelines Cohort Study
NBER Working Papers · 2026 · Gaia Bagnasco、Pieter Bakx、Stijn Coremans、Bram Wouterse

中文摘要

我们分析荷兰65岁及以上人口中认知障碍与长期照护使用之间的关联。为此,我们使用与荷兰统计局提供的行政记录相匹配的Lifelines队列研究数据。我们发现,在认知障碍者中,长期照护的使用集中于一个子群体:42%的认知障碍者未使用任何长期照护。与此同时,使用长期照护的认知障碍者支出较高,尤其是居住在护理院时。进一步分析表明,许多认知障碍者报告存在功能受限,且认知障碍与长期照护使用之间的关联,在这些功能受限之外依然存在。这些发现凸显了认知障碍的重要性:研究在解释长期照护使用的决定因素时应将其纳入考量,政策改革在根据老年人需求调整长期照护项目时也应予以考虑。

Abstract

We analyze the association between cognitive impairments and long-term care use in the 65+ population in the Netherlands. For this, we use data from the Lifelines Cohort Study that are linked to administrative records available through Statistics Netherlands. We find that, among those with cognitive impairments, long-term care use is concentrated in a subgroup: 42% of those with cognitive impairments do not use any long-term care. At the same time, individuals with cognitive impairments who use long-term care have high expenditures, in particular when living in nursing homes. Further analyses reveal that many individuals with cognitive impairments report functional limitations and that cognitive impairment is associated with long-term care use above and beyond these impairments. These findings highlight the importance of taking cognitive impairments into account when seeking to explain the determinants of long-term care use in research and when tailoring long-term care programs to the needs of the elderly when considering policy reforms.
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