Trajectories of disability and long-term care utilization after acute health events

Judite Gonçalves, Luís Filipe, Courtney H. Van Houtven

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Hip fractures, strokes, and heart attacks are common acute health events that can lead to long-term disability, care utilization, and unmet needs. However, such impacts, especially in the long term, are not fully understood. Using data from the Health and Retirement Study, 1992–2018, this study examines the long-term trajectories of individuals suffering such health shocks, comparing with individuals not experiencing health shocks. Hip fracture, stroke, and heart attack are confirmed to have severe implications for disability. In most cases of stroke and heart attack, informal caregivers provide the daily support needed by survivors, whereas following hip fracture, nursing home care is more relevant. These health shocks put individuals on worse trajectories of disability, care utilization, and unmet needs. There is no long-term recovery or convergence with individuals who do not suffer shocks. Unmet need is prevalent, even pre-shock and among individuals who do not experience health shocks, emphasizing the importance of preventative care measures. These findings support policy action to ensure hospitalized individuals, especially those aged 50 and above, receive rehabilitative services and other post-acute care. Furthermore, hospitalization is an event that requires the detection and addressing of unmet care needs beyond the short run.

Original languageEnglish
JournalJournal of Aging and Social Policy
Publication statusAccepted/In press - 2023


  • Event study
  • formal home care
  • health shock
  • informal care
  • limitations in activities of daily living
  • nursing home care
  • unmet need


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