Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Age Ageing. 2022 Oct 6;51(10). doi: 10.1093/ageing/afac228.
populations are considered to have an 'unmet need' when they could benefit from, but do not get, the necessary support. Policy efforts to achieve equitable access to long-term care require an understanding of patterns of unmet need. A systematic review was conducted to identify factors associated with unmet need for support to maintain independence in later life.
seven bibliographic databases and four non-bibliographic evidence sources were searched. Quantitative observational studies and qualitative systematic reviews were included if they reported factors associated with unmet need for support to maintain independence in populations aged 50+, in high-income countries. No limits to publication date were imposed. Studies were quality assessed and a narrative synthesis used, supported by forest plots to visualise data.
forty-three quantitative studies and 10 qualitative systematic reviews were included. Evidence across multiple studies suggests that being male, younger age, living alone, having lower levels of income, poor self-rated health, more functional limitations and greater severity of depression were linked to unmet need. Other factors that were reported in single studies were also identified. In the qualitative reviews, care eligibility criteria, the quality, adequacy and absence of care, and cultural and language barriers were implicated in unmet need.
this review identifies which groups of older people may be most at risk of not accessing the support they need to maintain independence. Ongoing monitoring of unmet need is critical to support policy efforts to achieve equal ageing and equitable access to care.
当人们有需要但却无法获得必要的支持时，就可以认为他们存在“未满足的需求”。为了实现长期护理的公平获取，政策努力需要了解未满足需求的模式。本系统评价旨在确定与老年人维持独立所需支持的未满足需求相关的因素。
我们检索了 7 个文献数据库和 4 个非文献证据来源。如果研究报告了与高收入国家 50 岁及以上人群维持独立所需支持的未满足需求相关的因素，那么就可以将其纳入定量观察性研究和定性系统评价。未对发表日期设限。我们对研究进行了质量评估，并使用叙述性综合方法进行分析，同时使用森林图直观展示数据。
我们纳入了 43 项定量研究和 10 项定性系统评价。多项研究的证据表明，男性、年龄较小、独居、收入较低、自我评估健康状况较差、功能障碍程度较高和抑郁程度较严重与未满足的需求相关。在单篇研究中也报告了其他一些因素。在定性综述中，护理资格标准、护理的质量、充足性和缺乏以及文化和语言障碍都与未满足的需求有关。
本综述确定了哪些老年人群体可能最有风险无法获得维持独立所需的支持。持续监测未满足的需求对于支持实现平等老龄化和公平获取护理的政策努力至关重要。
