在具有智力/发育障碍的双重符合条件的非老年人中,机构安置风险的州差异
Sophia Jan1, Caren Steinway2, Colleen Brensinger3
1Department of Pediatrics, Northwell Health, New Hyde Park, NY, 11040, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Pediatrics, Hempstead, NY, USA; Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA.
增加对家庭和社区服务 (HCBS) 的投资,可以减少智力/发育障碍 (IDD) 的非老年人机构安置. 较高的HCBS支出与较低的制度化风险有关,特别是在支持较大的州.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 关于残疾人的研究.
背景情况:
- 长期服务和支持 (LTSS) 占医疗补助支出的很大一部分,家庭和社区服务 (HCBS) 资格在州一级有显著差异.
- 对于弱势群体来说,了解影响机构安置的因素至关重要.
研究的目的:
- 调查居住状态和HCBS支出如何影响智力/发育障碍 (IDD) 的非老年成年人中制度化的风险,他们有资格获得医疗保险和医疗补助.
- 确定减少对机构护理的依赖的政策影响.
主要方法:
- 一项回顾性队列研究利用了从2008年至2012年的Medicaid Analytic eXtract和Medicare数据.
- 包括在社区环境中居住的159,275名具有智力/发育障碍 (IDD) 的双重资格的成年人 (18-64岁).
- 基于州和基准HCBS支出,分析了机构安置的危险比率.
主要成果:
- 4.4%的参与者有机构安置要求.
- 与佛罗里达州相比,俄俄州和加利福尼亚州的制度化风险更高.
- 基线HCBS支出每增加1万美元都与机构安置风险降低有关.
结论:
- 调查结果表明,增加对HCBS的投资和获得HCBS的机会可以减少非老年残疾人的机构护理需求.
- 政策努力应集中在扩大HCBS,以支持这一群体的长期护理需求.
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