摘要
【Abstract】【Background】Unmet social and caregiving needs can make caregiving for a person with dementia more difficult. Although national policy encourages adoption of systematic screening for health‐related social risks (HRSRs) in clinical settings, the accuracy of these risk‐based screening tools for detecting unmet social needs is unknown.【Methods】We used baseline data from dementia caregivers (N = 343) enrolled in a randomized controlled trial evaluating CommunityRx‐Dementia, a social care intervention conducted on Chicago's South Side. We assessed caregivers' (1) unmet social and caregiving needs by querying need for 14 resource types and (2) HRSRs using the Center for Medicare & Medicaid Services (CMS) Accountable Health Communities (AHC) screening tool. Using unmet social needs as the reference, we examined the sensitivity of the AHC tool to detect food, housing, and transportation needs. Analyses were stratified by gender.【Results】Most caregivers were women (78%), non‐Hispanic (96%), Black (81%), partnered (58%) and had an annual household income ≥$50K (64%). Unmet social and caregiving needs were similarly prevalent among women and men caregivers (87% had ≥1 need, 43% had ≥5 needs). HRSRs were also prevalent. The most common HRSR was lack of social support (45%). Housing instability, difficulty with utilities and having any HRSRs were significantly more prevalent among women (all p < 0.05). The AHC screener had low sensitivity for detecting unmet food (39%, 95% confidence interval [CI]: 27%–53%), housing (42%, 95% CI: 31%–53%), and transportation (22%, 95% CI: 14%–31%) needs. Sensitivity did not differ by gender for food (41% for women and 30% for men, p = 0.72) or housing (44% for women and 29% for men, p = 0.37) needs. For transportation needs, sensitivity was 27% for women versus 0% for men (p = 0.01).【Conclusions】Men and women caregivers have high rates of unmet social needs that are often missed by the CMS‐recommended risk‐based screening method. Findings indicate a role for need‐based screening in implementing social care.
摘要译文
【摘要】【背景】未满足的社交和照料需求可以使痴呆症患者更加困难。Although national policy encourages adoption of systematic screening for health‐related social risks (HRSRs) in clinical settings, the accuracy of these risk‐based screening tools for detecting unmet social needs is unknown.【Methods】We used baseline data from dementia caregivers (N = 343) enrolled in a randomized controlled trial evaluating CommunityRx‐Dementia, a social care intervention conducted on Chicago's South Side.我们通过查询需要14种资源类型的需求以及（2）使用Medicare＆Medicaid Services中心（CMS）责任健康社区（AHC）筛查工具来评估护理人员的（1）未满足的社交和照料需求。使用未满足的社会需求作为参考，我们检查了AHC工具在检测食物，住房和运输需求方面的敏感性。分析按性别进行分层。结果】大多数护理人员是女性（78％），非希斯邦（96％），黑人（81％），合作（58％），年收入≥50K（64％）。在男女护理人员中，未满足的社交和照料需求同样普遍（有87％的需求≥1，有43％的人有≥5个需求）。HRSR也很普遍。最常见的HRSR是缺乏社会支持（45％）。住房不稳定，公用事业的困难和任何HRSR在女性中的普遍性明显更为普遍（所有p <0.05）。AHC筛选器对检测未经满足的食物的敏感性低（39％，95％置信区间[CI]：27％–53％），住房（42％，95％CI：31％–53％）和运输（22％，95％，95％CI：14％–31％）。食物的敏感性没有差异（女性为41％，男性为30％，p = 0.72）或住房（女性为44％，男性为29％，p = 0.37）。对于运输需求，女性的敏感性为27％，而男性为0％（p = 0.01）。【结论】男女护理人员的社会需求率很高，而基于CMS的基于风险的筛查方法通常会忽略这一点。调查结果表明，基于需求的筛查在实施社会护理中的作用。
Victoria A. Winslow (0000-0001-7913-683X) [1];Stacy Tessler Lindau [2];Elbert S. Huang [3];Spencer Asay [4];Amber E. Johnson [5];Soo Borson (0000-0003-2185-768X) [6];Katherine Thompson [7];Jennifer A. Makelarski [8];. Caring for dementia caregivers: How well does social risk screening reflect unmet needs?[J]. Journal of the American Geriatrics Society, 2025,73(1): 63-73