title: Unmet needs for home and community-based services among frail older Americans and their caregivers.
abstract: OBJECTIVE
  This study examined unmet needs for home- and community-based services (HCBS) among frail older Americans.
  
  
  METHODS
  Using population-based sample from the National Long-Term Care Survey, a hierarchical logistic regression analysis was conducted to examine the predictors of unmet needs for seven types of HCBS.
  
  
  RESULTS
  Lack of awareness, reluctance, unavailability, and affordability of services were the main reasons for unmet needs for HCBS. Factors that were associated with unmet needs included Black race/ethnicity, greater care needs (functional limitations and behavioral problems), and less informal support (substitute help and family agreement).
  
  
  CONCLUSIONS
  It is important to identify risk factors that may lead to older adults' unmet needs for HCBS. The findings of this study charge researchers to look beyond service utilization and give more attention to service needs among those who did or could not access the services.
authors.affiliation: University of Maryland School of Social Work, Baltimore, MD, USA. bcasado@ssw.umaryland.edu.
authors.forename: Banghwa Lee
authors.initials: BL
authors.lastname: Casado
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: van Vulpen
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Davis
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D003153:Community Health Services / Q000458:organization & administration*; D016001:Confidence Intervals; D005006:Ethnicity; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011594:Psychometrics; D012307:Risk Factors; D012944:Social Support; D014481:United States