检查自1915年提供的自主服务的跨州差异 (c) 老年人的豁免
Natalie R Turner1, Carli Friedman2
1School of Social Work, University of Washington, Seattle, Washington, USA.
Journal of aging & social policy
|October 6, 2025
概括
自主指导允许老年人对长期服务进行控制. 医疗补助家庭和社区服务豁免的州差异显著影响老年人对这种模式的访问和经验.
科学领域:
- 老年学是一门学科.
- 医疗保健服务研究 医疗服务研究
- 公共政策 公共政策
背景情况:
- 自主导向赋予老年人长期服务和支持的选择和控制权.
- 国家层面的政策决定了自我指导的特点,影响了程序的可访问性和利用性.
研究的目的:
- 为了确定医疗补助家庭和社区服务 (HCBS) 1915 (c) 豁免中自主导模式的跨州变化.
- 分析国家特定的设计元素如何影响自导实现和参与者体验.
主要方法:
- 混合方法方法结合框架分析和描述性统计.
- 分析了2023财年60个医疗补助HCBS 1915 ((c) 豁免服务于老年人.
- 基于程序价值,能力确定和参与者权威的定性分类.
主要成果:
- 在自导程序设计中观察到的跨州显著差异.
- 在目标,预计支出和自主导的符合条件的豁免服务数量方面存在很大差异.
- 居住国在很大程度上影响了老年人对自主导向的访问和体验.
结论:
- 医疗补助HCBS 1915 (c) 豁免在自我指导方面表现出相当大的设计异质性.
- 国家政策在塑造老年人自我指导的有效性和可访问性方面发挥着至关重要的作用.
- 各国可以利用交叉豁免的见解来改进和改进他们的自我指导计划设计.
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