Assistant Professor, Rory Meyers College of Nursing, New York University, New York, New York, USA.
Nurse Practitioner, Massachusetts General Hospital, Boston, Massachusetts, USA.
J Aging Soc Policy. 2022 Nov 2;34(6):976-1002. doi: 10.1080/08959420.2021.2024411. Epub 2022 Feb 7.
Programs of All-Inclusive Care for the Elderly (PACE) are an effective approach to improve care quality and delay institutional admissions especially for Black and Hispanic older adults who have seen a disproportionate rise in nursing home use. Guided by Andersen's Behavioral Model of Health Services Use and employing focus groups and one-on-one interviews, we qualitatively examined factors influencing access to and use of PACE by Black and Hispanic older adults. The study sample consisted of thirty-two PACE enrollees, six marketing-team members, and four family-caregivers from three PACE sites in a northeast urban city. Informed knowledge, cultural beliefs, and attitudes toward PACE were found to affect access. Community resources, available services, and care quality facilitated enrollment/participation. Barriers identified included poor dissemination of information and inadequate emphasis on staff's sensitivity to enrollees' cultural and disability differences. Findings will help healthcare leaders capitalize on facilitators and address barriers to enhance access and use of PACE by racial and ethnic minority older adults.
老年人全方位照护计划（PACE）是一种提高护理质量和延迟机构入住率的有效方法，特别是对于那些使用养老院比例不成比例上升的黑人和西班牙裔老年人。本研究以安德森的卫生服务使用行为模型为指导，采用焦点小组和一对一访谈的方式，定性研究了影响黑人和西班牙裔老年人获得和使用 PACE 的因素。研究样本包括来自东北部城市的三个 PACE 服务点的 32 名 PACE 参与者、6 名营销团队成员和 4 名家庭护理人员。研究发现，有关 PACE 的知识、文化信仰和态度会影响获取途径。社区资源、可用服务和护理质量促进了参与。确定的障碍包括信息传播不畅和对工作人员对参与者的文化和残疾差异的敏感性不够重视。研究结果将有助于医疗保健领导者利用促进因素并解决障碍，以增加少数族裔老年人获得和使用 PACE 的机会。
