Abstract：
BACKGROUND: The availability of population-level data on unmet needs for long-term services and supports (LTSS) is limited at state and national levels. Data on unmet LTSS needs can improve our understanding of disparities and relationships with health outcomes.
OBJECTIVE: 1) Explore differences in unmet LTSS needs by socio-demographic characteristics, including age, sex, race/ethnicity, metropolitan status, sexual orientation, and socio-economic status; and 2) Examine associations between unmet LTSS needs and health/preventative healthcare outcomes.
METHODS: We used the 2021 Behavioral Risk Factor Surveillance System (BRFSS) core survey and state-added LTSS questions to analyze a sample of adults with LTSS needs in Texas (N = 1232). We compared socio-demographic characteristics between adults with and without unmet LTSS needs. We conducted modified-Poisson regressions to estimate unadjusted and adjusted risk ratios (with 95 % confidence intervals) for each health/preventative healthcare outcome among adults with unmet LTSS needs. Health outcomes included health status, healthy days-physical health, healthy days-mental health, suicide ideation, and multiple chronic conditions. Preventative healthcare outcomes included routine check-up and flu vaccine.
RESULTS: Among adults with LTSS needs, those with unmet LTSS needs were statistically significantly more likely to be younger (age<65), female, higher educational attainment, and non-straight sexual orientation. After controlling for socio-demographic variables, having unmet needs for LTSS was significantly associated with poorer physical and mental health outcomes and suicide ideation.
CONCLUSIONS: Improved data collection on unmet needs LTSS can assist policymakers, particularly at the state level in guiding reforms to reduce disparities in access to home and community-based services (HCBS) and improve health outcomes.
OBJECTIVE: 1) Explore differences in unmet LTSS needs by socio-demographic characteristics, including age, sex, race/ethnicity, metropolitan status, sexual orientation, and socio-economic status; and 2) Examine associations between unmet LTSS needs and health/preventative healthcare outcomes.
METHODS: We used the 2021 Behavioral Risk Factor Surveillance System (BRFSS) core survey and state-added LTSS questions to analyze a sample of adults with LTSS needs in Texas (N = 1232). We compared socio-demographic characteristics between adults with and without unmet LTSS needs. We conducted modified-Poisson regressions to estimate unadjusted and adjusted risk ratios (with 95 % confidence intervals) for each health/preventative healthcare outcome among adults with unmet LTSS needs. Health outcomes included health status, healthy days-physical health, healthy days-mental health, suicide ideation, and multiple chronic conditions. Preventative healthcare outcomes included routine check-up and flu vaccine.
RESULTS: Among adults with LTSS needs, those with unmet LTSS needs were statistically significantly more likely to be younger (age<65), female, higher educational attainment, and non-straight sexual orientation. After controlling for socio-demographic variables, having unmet needs for LTSS was significantly associated with poorer physical and mental health outcomes and suicide ideation.
CONCLUSIONS: Improved data collection on unmet needs LTSS can assist policymakers, particularly at the state level in guiding reforms to reduce disparities in access to home and community-based services (HCBS) and improve health outcomes.
摘要：
背景：关于未满足的长期服务和支持（LTSS）需求的人口级别数据的可用性在州和国家级别上受到限制。关于未满足的LTSS需求的数据可以提高我们对差异和与健康结果的关系的理解。
目标：1）通过社会人口统计学特征探索未满足的LTSS需求的差异，包括年龄,性别,种族/民族,大都市地位，性取向,和社会经济地位；2）检查未满足的LTSS需求与健康/预防性医疗保健结果之间的关联。
方法：我们使用2021年行为风险因素监测系统（BRFSS）核心调查和国家增加的LTSS问题来分析德克萨斯州有LTSS需求的成年人样本（N=1232）。我们比较了有和没有未满足LTSS需求的成年人的社会人口统计学特征。我们进行了改进的泊松回归，以估计未满足LTSS需求的成年人中每个健康/预防性医疗保健结果的未调整和调整的风险比（具有95％置信区间）。健康结果包括健康状况，健康的日子-身体健康，健康的日子-心理健康，自杀意念,和多种慢性疾病。预防性医疗结果包括常规检查和流感疫苗。
结果：在有LTSS需求的成年人中，具有未满足的LTSS需求的人在统计学上显着更年轻（年龄<65），女性,较高的教育程度，和非直率的性取向。在控制了社会人口统计学变量之后，对LTSS的需求未得到满足与较差的身心健康结局和自杀意念显著相关.
结论：改进未满足需求的数据收集LTSS可以帮助政策制定者，特别是在州一级指导改革，以减少获得家庭和社区服务（HCBS）的差距，并改善健康结果。
目标：1）通过社会人口统计学特征探索未满足的LTSS需求的差异，包括年龄,性别,种族/民族,大都市地位，性取向,和社会经济地位；2）检查未满足的LTSS需求与健康/预防性医疗保健结果之间的关联。
方法：我们使用2021年行为风险因素监测系统（BRFSS）核心调查和国家增加的LTSS问题来分析德克萨斯州有LTSS需求的成年人样本（N=1232）。我们比较了有和没有未满足LTSS需求的成年人的社会人口统计学特征。我们进行了改进的泊松回归，以估计未满足LTSS需求的成年人中每个健康/预防性医疗保健结果的未调整和调整的风险比（具有95％置信区间）。健康结果包括健康状况，健康的日子-身体健康，健康的日子-心理健康，自杀意念,和多种慢性疾病。预防性医疗结果包括常规检查和流感疫苗。
结果：在有LTSS需求的成年人中，具有未满足的LTSS需求的人在统计学上显着更年轻（年龄<65），女性,较高的教育程度，和非直率的性取向。在控制了社会人口统计学变量之后，对LTSS的需求未得到满足与较差的身心健康结局和自杀意念显著相关.
结论：改进未满足需求的数据收集LTSS可以帮助政策制定者，特别是在州一级指导改革，以减少获得家庭和社区服务（HCBS）的差距，并改善健康结果。
