The Milbank Memorial Fund is an endowed operating foundation that publishes The Milbank Quarterly, commissions projects, and convenes state health policy decision makers on issues they identify as important to population health.
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The Center for Evidence-based Policy at Oregon Health & Science University is a national leader in evidence-based decision making and policy design.
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We publish The Milbank Quarterly, as well as reports and issues briefs on topics important to population health.
March 2004 (Volume 82)
March 2004 | Brenda C. Spillman
Recent research indicates declining age-adjusted chronic disability among older Americans, which might moderate health care costs in the coming decades. This study examines the trend’s underlying components using data from the 1984-1999 National Long-Term Care Surveys to better understand the reasons for the declines and potential implications for acute and long-term care. The reductions occurred primarily for activities like financial management and shopping. Assistance with personal care activities associated with greater frailty fell less, and independence with assistive devices rose. Institutional residence was stable. More needs to be known about the extent to which these declines reflect environmental improvements allowing greater independence at any level of health, rather than improvements in health, before concluding that the declines will mean lower costs.
Author(s): Brenda C. Spillman
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Volume 82, Issue 1 (pages 157–194)
Published in 2004
Genetic Modification of Preimplantation Embryos: Toward Adequate Human Research Policies
Addressing the “Risk Environment” for Injection Drug Users: The Mysterious Case of the Missing Cop