阿尔茨海默病及相关痴呆患者的 HCBS 服务支出与疗养院安置：种族因素重要吗？
HCBS Service Spending and Nursing Home Placement for Patients With Alzheimer's Disease and Related Dementias: Does Race Matter?
机构信息
Department of Public Health Sciences, 6923University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
Department of Public Health Sciences, 123964University of Chicago, Chicago, IL, USA.
出版信息
J Appl Gerontol. 2022 Mar;41(3):638-649. doi: 10.1177/07334648211048187. Epub 2021 Oct 7.
Abstract
OBJECTIVES
We examined the extent to which home and community-based services (HCBS) spending affected the likelihood of nursing home (NH) placement among black and white HCBS users with Alzheimer's disease and related dementias (ADRD).
METHODS
The study population included new HCBS users with ADRD between 2010 and 2013 ( = 1,046,200).
RESULTS
We found that a one hundred dollar increase in monthly HCBS spending was associated with a 0.3 percentage points decrease in the NH placement rate among Whites, but a 0.3 percentage points increase in the NH placement rate among Blacks. The overall NH placement rate was 68.2% and 56.7% for Whites and Blacks, respectively.
DISCUSSION
A higher HCBS spending was associated with a decreased likelihood of NH placements for Whites but not for Blacks. It is important to understand how states' HCBS expansion efforts influence Blacks and Whites with ADRD so that resources can be tailored to communities with different race-mix.
摘要
目的
本研究旨在探究，对于患有阿尔茨海默病及相关痴呆症（ADRD）的白人和黑人，居家和社区为基础的服务（HCBS）支出在多大程度上影响其入住养老院的可能性。
方法
本研究纳入了 2010 年至 2013 年间新接受 HCBS 的 ADRD 患者（n=1,046,200）。
结果
我们发现，HCBS 月支出每增加 100 美元，白人入住养老院的比例会降低 0.3 个百分点，而黑人入住养老院的比例则会增加 0.3 个百分点。白人的整体入住养老院的比例为 68.2%，黑人的这一比例为 56.7%。
讨论
HCBS 支出的增加与白人入住养老院的可能性降低有关，但与黑人无关。了解各州 HCBS 扩张对患有 ADRD 的白人和黑人的影响，对于将资源针对性地提供给不同种族混合的社区是很重要的。
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