Department of Family Medicine and Community Health, Disability, Health and Employment Policy Unit, University of Massachusetts Medical School, Shrewsbury, MA 01545, USA.
Disabil Health J. 2011 Oct;4(4):219-28. doi: 10.1016/j.dhjo.2011.08.003.
Home and community-based services (HCBS) are vital to the health and well-being of persons with disabilities. However, no previous population-based studies have examined the prevalence of unmet needs for HCBS among working-age persons with disabilities. The purpose of this report is to document the prevalence of unmet need for HCBS among a representative sample of working-age persons with disabilities in Massachusetts.
Data from the 2007 Massachusetts Survey of Unmet Needs of Adults with Disabilities were analyzed. HCBS included in-home help, case-management, information, access to medical care, physical and occupational therapy, prescription drugs, meals, assistive technology, home adaptation, transportation, need for assistance with activities of daily living and instrumental activities of daily living (IADL) services.
The prevalence of unmet need for HCBS was high, with more than two-thirds of respondents reporting at least 1 unmet need and more than 1 in 4 respondents reporting 4 or more unmet needs. The most prevalent unmet need included the need for information for disability-related services and legal rights, need for primary, specialty, and mental health care, case management services and the unmet need for IADL services. The unmet needs for HCBS were categorized into unmet needs relating to access to information and services and those relating to in-home supports.
The study findings support the need to broaden the scope of HCBS for working-age persons with disabilities and to implement community-based programs such as improving access to information for services and benefits and enhancing access to in-home supports.
家庭和社区为基础的服务(HCBS)对残疾人士的健康和福祉至关重要。然而,以前没有基于人群的研究调查过有工作能力的残疾人士对 HCBS 的未满足需求的流行程度。本报告的目的是记录马萨诸塞州有代表性的有工作能力的残疾人士样本中对 HCBS 的未满足需求的流行程度。
分析了 2007 年马萨诸塞州残疾成年人未满足需求调查的数据。HCBS 包括家庭帮助、个案管理、信息、获得医疗保健、物理和职业治疗、处方药、膳食、辅助技术、家庭适应、交通、日常生活活动和工具性日常生活活动(IADL)服务的协助需求。
HCBS 的未满足需求的流行程度很高,超过三分之二的受访者报告至少有 1 项未满足的需求,超过 1/4 的受访者报告有 4 项或更多未满足的需求。最常见的未满足需求包括与残疾相关的服务和法律权利的信息需求、需要初级、专科和精神保健、个案管理服务以及 IADL 服务的未满足需求。HCBS 的未满足需求分为与获取信息和服务有关的未满足需求以及与家庭支持有关的未满足需求。
研究结果支持扩大有工作能力的残疾人士的 HCBS 范围的必要性,并实施基于社区的计划,例如改善对服务和福利的信息获取,并加强对家庭支持的获取。