View Research by Author - Anthony T. Lo Sasso

Citation URL: http://www.urban.org/AnthonyTLoSasso

Adult daughters have traditionally served as primary caregivers for frail unmarried adults, but the levels of care they provided in the past may interfere with their growing work responsibilities. This paper examines the impact of time transfers to elderly parents on labor supply at midlife. Using a sample of women ages 55 to 67 in the Health and Retirement Study, we estimate panel data models of annual hours of paid work controlling for the endogeneity of time assistance to parents. The results indicate that time help to parents strongly reduces female labor supply at midlife. (Inquiry 43(3): 195-210, 2006.)

This paper contrasts changes that took place among urban safety net hospitals (SNHs) during the period 1990 to 1997 with changes that occurred at other urban facilities. We use data from American Hospital Association Annual Survey and define three groups of SNHs based on 1990 provision of uncompensated care (UC): those that provided a large share of UC in their market; those for which UC imposed a burden because it represented a large share of their expenses; and those meeting both conditions. We found that, through 1997, high market share/high burden SNHs lost service volume relative to non-SNHs, but did not undertake reductions in staffing levels and expenses or reduce UC. High market share only hospitals were similar to non-SNHs, but reduced their UC market share and were more likely to enter into a merger. High burden only SNHs were most likely to close, but those that remained open experienced growth in volume and maintained their financial position. (Health Affairs 2001 July/August; 20(4):159-168)

This paper examines the effect of changing state policy, such as Medicaid eligibility, payment generosity, and HMO enrollment, on provision of hospital uncompensated care. Using national data from the American Hospital Association for the period from 1990 through 1995, we find that not-for-profit and public hospitals’ uncompensated care levels respond positively to Medicaid payment generosity, although the size of the effect is small. Not-for-profit hospitals respond negatively to Medicaid HMO penetration. Results suggest that public insurance payment generosity is an effective but inefficient policy instrument for influencing uncompensated care among not-for-profit hospitals. Further in localities with high HMO penetration or high penetration of for-profit hospitals, it may be necessary to establish explicit payments for car of the uninsured. (Inquiry 2000 Fall; 37: 253-267).

The costs of providing care informally at home to frail elderly persons can be substantial, especially if caregivers are forced to interrupt their careers or retire early when they provide care. This brief summarizes findings from a recent Urban Institute study of the characteristics of persons in their fifties and early sixties who provide care to their elderly parents and the trade-offs that families face when they divide their time between the provision of informal care and paid work. The results suggest that devoting time to the care of elderly parents may be compatible with full-time paid employment at midlife.

Although the family has traditionally been the primary caregiver for the frail elderly, the rising labor force participation rates of married women may interfere with their historical caregiving responsibilities. This paper explores time transfers to elderly parents and their impact on labor supply for persons at midlife. We estimate simultaneous panel data models of annual hours of paid work and the provision of time assistance to parents for a sample of men and women ages 53-65 in the Health and Retirement Study. Our results indicate that time help to parents substantially reduces labor supply for both women and men.

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