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.

中文翻译：

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堪萨斯州 COVID-19 大流行期间家庭和社区服务中的护理协调和备用计划的经验


COVID-19 大流行是一次紧急事件，在此期间，备用计划变得非常重要。尽管医疗补助资助的家庭和社区服务 (HCBS) 需要备用计划作为关键风险管理策略，但我们对其有效性知之甚少。本研究的目的是探讨堪萨斯州 COVID-19 大流行期间备用计划和护理协调是否满足 HCBS 消费者的需求。在基于社区的参与性研究框架内使用了交互式、聚合的混合方法设计。数据来自对 HCBS 消费者、护理人员、工作人员和提供者的 70 次深度访谈，以及 100 份消费者调查，询问堪萨斯州 COVID-19 大流行期间接受或提供护理的经历。归纳编码用于识别定性数据的主要主题。定量数据采用描述性和双变量分析。三分之一的受访者表示没有备用计划，39% 的受访者至少连续两周没有正式的家庭护理服务。大流行加剧并暴露了管理式医疗环境中医疗协调和备份计划的缺陷。受访者表示，疫情期间非常需要后备人员，但很难找到这些支持。尽管家人、朋友和提供者介入帮助填补空白，但仍然有许多未得到满足的护理需求。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，这些计划可以成功利用，以避免护理中断。