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Racial and ethnic differences in unmet needs among older adults receiving publicly-funded home and community-based services.
Fabius, Chanee D; Parikh, Romil; Wolf, Jack M; Giordano, Stephanie; Fashaw-Walters, Shekinah; Jutkowitz, Eric; Shippee, Tetyana.
Afiliación
  • Fabius CD; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
  • Parikh R; Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
  • Wolf JM; Division of Biostatistics and Health Data Science, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
  • Giordano S; Human Services Research Institute, Cambridge, Masssachusetts, USA.
  • Fashaw-Walters S; Division of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota, USA.
  • Jutkowitz E; Department of Health Services, Policy, and Practice, Brown University, Providence, Rhode Island, USA.
  • Shippee T; Division of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota, USA.
J Am Geriatr Soc ; 2024 Aug 29.
Article en En | MEDLINE | ID: mdl-39210674
ABSTRACT

BACKGROUND:

Unmet need for home and community-based services (HCBS) may disparately impact older adults from racial and ethnic minoritized groups. We examined racial and ethnic differences in unmet need for HCBS among consumers ≥65 years using publicly funded HCBS.

METHODS:

We analyzed the National Core Indicators-Aging and Disability survey data (2015-2019) from 21,739 community-dwelling HCBS consumers aged ≥65 years in 23 participating states. Outcome measures included self-reported unmet need in six service types (i.e., personal care, homemaker/chore, delivered meals, adult day services, transportation, and caregiver support). Racial and ethnic groups included non-Hispanic Black, Asian, non-Hispanic White, Hispanic, and multiracial groups. Logistic regression models examined associations between race and ethnicity and unmet need, adjusting for sociodemographic, health, and HCBS program (i.e., Medicaid, Older Americans Act [OAA], Program for All-Inclusive Care for the Elderly [PACE]) characteristics, and use of specific service types.

RESULTS:

Among 21,739 respondents, 23.3% were Black, 3.4% were Asian, 10.8% were Hispanic, 58.8% were non-Hispanic White, and 3.7% were multiracial or identified with other races/ethnicities. Asian and Black consumers had higher odds of reporting unmet need in personal care than White consumers (adjusted odds ratio [aOR], 1.45, p value < 0.01; and aOR, 1.25, p < 0.001, respectively). Asian and Black consumers had significantly higher odds of unmet need in adult day services versus White consumers (aOR, 1.94, p < 0.001 and aOR, 1.39, p < 0.001, respectively). Black consumers had higher odds of unmet need versus non-Hispanic White consumers in meal delivery and caregiver support services (aOR, 1.29; p < 0.01; and aOR 1.26, p < 0.05, respectively). Race and ethnicity were not significantly associated with experiencing unmet need for homemaker/chore or transportation services.

CONCLUSIONS:

Future research should identify driving forces in disparities in unmet need to develop culturally appropriate solutions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Am Geriatr Soc Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Am Geriatr Soc Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos