Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, PA, USA.
J Appl Gerontol. 2022 Aug;41(8):1870-1877. doi: 10.1177/07334648221094578. Epub 2022 May 20.
This study examines multiple services are used across a population and the association between type and amount of services use with level of disability and living arrangement.
This is a descriptive cross-sectional analysis examining HCBS use among older Pennsylvanians from 2014 to 2016 enrolled in Pennsylvania's 1915(c) waiver program. Data were derived from Medicaid claims. Logistic regression and OLS regression were used to examine the association between service use and level of disability, controlling for age, gender, race, and other covariates.
People with Alzheimer's or a related dementia were more likely to use adult day care. People with higher ADL and IADL limitations were more likely to use higher amounts of PAS and less likely to have delivered meals.
These findings demonstrate HCBS is a complex package of services that are allocated regarding the level of need and resources available to individual program participants.
本研究考察了在一个人群中使用的多种服务，以及服务类型和使用量与残疾程度和生活安排之间的关系。
这是一项描述性的横断面分析，研究了 2014 年至 2016 年期间参加宾夕法尼亚州 1915(c)豁免计划的宾夕法尼亚州老年人的 HCBS 使用情况。数据来自医疗补助索赔。使用逻辑回归和 OLS 回归来检查服务使用与残疾程度之间的关联，同时控制年龄、性别、种族和其他协变量。
患有阿尔茨海默病或相关痴呆症的人更有可能使用成人日间护理。日常生活活动和工具性日常生活活动限制较高的人更有可能使用较高数量的 PAS，而不太可能接受送餐服务。
这些发现表明，HCBS 是一种复杂的服务包，根据个体项目参与者的需求水平和可用资源进行分配。
