Shippee Tetyana P, Duan Yinfei, Baker Zachary G, Parikh Romil, Bucy Taylor, Jutkowitz Eric
Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA.
Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.
J Aging Health. 2024 Jul 24:8982643241267378. doi: 10.1177/08982643241267378.
Despite an increased policy focused on home- and community-based services (HCBS), little is known about their quality of life (QoL)-a key measure of person-centered care. This paper addresses this gap by measuring consumers' self-reported QoL and identifying factors associated with disparities in QoL.
We analyzed the 2015-2016 National Core Indicators-Aging and Disability survey for 3426 respondents in Minnesota, using factor analyses to identify latent QoL domains. Multivariable regression models identified predictors of QoL domains.
Factor analyses identified three valid and reliable latent QoL domains: security, self-determination, and care experiences. Younger consumers with disabilities (versus consumers ≥65 years of age), minoritized racial/ethnic groups, consumers with hearing loss, without a spouse/domestic partner, and not living in consumer's own/family home reported significantly lower QoL in various domains ( < .001).
Disparities in HCBS consumer-reported QoL exist, necessitating equitable reforms to improve HCBS quality for its increasingly diversified consumer base.
尽管针对家庭和社区服务（HCBS）的政策关注度有所提高，但对于其生活质量（QoL）——以个人为中心的护理的一项关键衡量指标，我们却知之甚少。本文通过衡量消费者自我报告的生活质量并确定与生活质量差异相关的因素来填补这一空白。
我们分析了明尼苏达州3426名受访者的2015 - 2016年国家核心指标——老龄化与残疾调查，使用因子分析来确定潜在的生活质量领域。多变量回归模型确定了生活质量领域的预测因素。
因子分析确定了三个有效且可靠的潜在生活质量领域：安全感、自主决定权和护理体验。残疾的年轻消费者（与65岁及以上的消费者相比）、少数族裔群体、听力受损的消费者、没有配偶/同居伴侣以及不住在自己/家庭住所的消费者在各个领域的生活质量显著较低（<.001）。
家庭和社区服务消费者报告的生活质量存在差异，因此需要进行公平改革，以提高其日益多样化的消费者群体的家庭和社区服务质量。
