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双重资格受益人之间与初始类型的长期服务和支持相关的因素
Kun-Woo R Kim1, David G Stevenson2, Jennifer Kim3
1Department of Health Policy, Vanderbilt University, Nashville, TN, USA.
Journal of the American Medical Directors Association
|February 8, 2026
概括
具有复杂医疗需求的双重资格的老年人更有可能使用养老院进行初始的长期服务和支持 (LTSS). 黑人种族和女性性别与更高的家庭和社区服务 (HCBS) 使用有关.
科学领域:
- 老年学是一门学科.
- 医疗服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 老年人往往需要长期的服务和支持 (LTSS).
- 医疗补助家庭和社区服务 (HCBS) 和养老院 (NH) 护理是LTSS的主要选择.
- 医疗保险和医疗补助的双重资格影响了LTSS访问.
研究的目的:
- 调查与双重资格的老年人中HCBS和NH护理之间的初始选择相关的因素.
- 确定影响启动的长期服务和支持类型的个体特征.
主要方法:
- 一项队列研究利用了2002-2018年期间的医疗保险和医疗补助行政数据.
- 这项研究包括581名在LTSS启动时65岁或以上的双重符合条件的个人.
- 多变量后勤回归分析了社会人口统计学因素,健康状况和以前的医疗保健利用情况.
主要成果:
- 一半的参与者开始了HCBS,另一半开始了NH护理.
- 黑人种族和女性性别与开始HCBS的可能性更高有关.
- 老年,阿尔茨海默病和相关痴呆症 (ADRD),住院和高等教育预测了初始NH使用.
结论:
- 复杂的医疗需求,特别是ADRD,与初始LTSS的NH利用率更高有关.
- 种族和性别等社会人口统计因素影响HCBS和NH之间的选择.
- 了解这些因素对于公平的LTSS提供至关重要.
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