成人日间服务、有复杂需求的老年人健康公平与新冠疫情

Adult Day Services, Health Equity for Older Adults With Complex Needs, and the COVID-19 Pandemic.

机构信息

Tina R. Sadarangani is with the Rory Meyers College of Nursing, New York University, New York. Joseph E. Gaugler is with the School of Public Health, Division of Health Policy and Management, University of Minnesota, Minneapolis. Holly Dabelko-Schoeny is with the College of Social Work, Age-Friendly Innovation Center, Ohio State University, Columbus. Katherine A. Marx is with the School of Nursing, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD.

出版信息

Am J Public Health. 2022 Oct;112(10):1421-1428. doi: 10.2105/AJPH.2022.306968.

Abstract

Morbidity and mortality from COVID-19 have unduly affected older adults from racial and ethnic minority groups. In this article, we highlight the experiences and vulnerabilities of diverse older adults with complex health and social needs when their access to vital, but overlooked, community-based adult day service centers (ADSCs) was abruptly cut off during a pandemic. Pandemic-related ADSC closures left vulnerable older adults and their care partners without essential daily support and services, such as health monitoring and socialization. However, the magnitude of the impact of ADSC closures on well-being, particularly among members of racial/ethnic minority groups, has yet to be measured with any form of "big data" because large-scale, nationally representative data sets consisting of participant-level information and outcomes associated with ADSC participation do not yet exist. Unmet needs of older adults resulting from pandemic-related ADSC closures are underrecognized because of a lack of systematic data collection, undermining efforts to achieve health equity. We call on ADSCs to link rigorous collection of racial and ethnic data to quality measures of access to equitable "age-friendly" care as a means of better supporting diverse community-dwelling older adults beyond the COVID-19 pandemic. (. 2022;112(10):1421-1428. https://doi.org/10.2105/AJPH.2022.306968).

摘要

COVID-19 的发病率和死亡率不成比例地影响了来自少数族裔和种族群体的老年人。在本文中,我们强调了在大流行期间,当多样化的、健康状况复杂且有社会需求的老年人获得基本但被忽视的社区成人日间服务中心(ADSC)的机会突然被切断时,他们的经历和脆弱性。与大流行相关的 ADSC 关闭使脆弱的老年人及其护理伙伴失去了必要的日常支持和服务,例如健康监测和社交。然而,ADSC 关闭对幸福感的影响程度,特别是在少数族裔群体成员中,尚未通过任何形式的“大数据”来衡量,因为缺乏包含参与者信息和与 ADSC 参与相关结果的大规模、全国代表性数据集。由于缺乏系统的数据收集,老年人因与大流行相关的 ADSC 关闭而产生的未满足需求未得到充分认识,从而破坏了实现健康公平的努力。我们呼吁 ADSC 将收集种族和族裔数据与获取公平的“适合老年人”护理的质量措施联系起来,作为一种在 COVID-19 大流行之外更好地支持多样化的社区居住老年人的手段。(2022 年;112(10):1421-1428。https://doi.org/10.2105/AJPH.2022.306968)。

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