LaPierre Tracey A, Wendel Carrie L, Babitzke Jennifer, Sullivan Darcy L, Swartzendruber Lora, Olds Danielle M
University of Kansas Department of Sociology, 1415 Jayhawk Blvd, Fraser Hall #716, Lawrence, KS, 66045, USA; Healthcare Institute for Innovations in Quality, University of Missouri - Kansas City, 4401 Wornall Rd., Kansas City, MO, 64111, USA.
University of Kansas School of Social Welfare, 1545 Lilac Lane, Twente Hall, Lawrence, KS, 66045, USA.
Disabil Health J. 2025 Jul;18(3S):101677. doi: 10.1016/j.dhjo.2024.101677. Epub 2024 Jul 27.
The COVID-19 pandemic was an emergency event during which backup plans became widely relevant. Although backup plans are required for Medicaid-funded Home and Community Based Services (HCBS) as a key risk management strategy, we know little about their effectiveness.
The purpose of this study was to explore whether backup plans and care coordination met the needs of HCBS consumers during the COVID-19 pandemic in Kansas.
An interactive, convergent mixed-methods design within a community-based participatory research framework was used. Data came from 70 in-depth interviews with HCBS consumers, caregivers, workers, and providers, as well as 100 surveys from consumers, asking about experiences receiving or providing care during the COVID-19 pandemic in Kansas. Inductive coding was used to identify major themes for the qualitative data. Descriptive and bivariate analysis were used for quantitative data.
One-third of survey respondents reported not having a backup plan and 39% went without formal homecare services for at least 2 consecutive weeks. The pandemic exacerbated and exposed deficiencies in care coordination and backup plans in a managed care environment. Interview participants expressed great need for backup workers during the pandemic but struggled to find these supports. Although family, friends, and providers stepped in to help fill gaps, there remained many unmet care needs.
Findings indicate that improvements are needed in care coordination to support the development and maintenance of backup plans that can be successfully drawn on to avoid interruptions to care.
新冠疫情是一个应急事件，在此期间，备用计划变得广泛相关。虽然作为一项关键风险管理策略，医疗补助资助的居家和社区服务（HCBS）需要备用计划，但我们对其有效性知之甚少。
本研究旨在探讨在堪萨斯州的新冠疫情期间，备用计划和护理协调是否满足了HCBS消费者的需求。
采用基于社区参与性研究框架的交互式、收敛性混合方法设计。数据来自对70名HCBS消费者、护理人员、工作人员和提供者的深入访谈，以及来自消费者的100份调查问卷，询问他们在堪萨斯州新冠疫情期间接受或提供护理的经历。归纳编码用于确定定性数据的主要主题。描述性和双变量分析用于定量数据。
三分之一的调查受访者表示没有备用计划，39%的人连续至少两周没有接受正规的居家护理服务。疫情加剧并暴露了管理式护理环境中护理协调和备用计划的不足。访谈参与者表示在疫情期间非常需要备用工作人员，但难以找到这些支持。尽管家人、朋友和提供者介入帮助填补缺口，但仍有许多未满足的护理需求。
研究结果表明，需要改进护理协调，以支持备用计划的制定和维护，这些计划可以成功启用，以避免护理中断。
