Home Health Care and Patterns of Subsequent VA and Medicare Health Care Utilization for Veterans

COVID-19 patients represent a new and distinct population in home health care. Little is known about health care utilization and incremental improvements in health for recovering COVID-19 patients after admission to home health care. Using a retrospective observational cohort study of 5452 episodes of home health care admitted to a New Jersey Home Health Agency between March 15 and May 31, 2020, this study describes COVID-19 Home Health Care (HHC) patients ( n = 842) and compare them to the general HHC population ( n = 4610). COVID HHC patients differ in significant ways from the typical HHC population. COVID patients were more likely to be 65 years of age and younger (41% vs 26%), be from a racial/ethnic minority (60% vs 31%), live with another person (85% vs 76%), have private insurance (28% vs 16%), and began HHC with greater independence in activities-of-daily-living (ADL/IADLs). COVID patients received fewer overall visits than their non-COVID counterparts (11.7 vs 16.3), although they had significantly more remote visits (1.7 vs 0.3). Multivariate analyses show that COVID patients early in the pandemic were 34% (CI, 28%-40%) less likely to be hospitalized and demonstrated significantly greater improvement in all the outcome measures examined compared to the general home health population.

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Home Health Care Utilization: A Review of the Research for Social Work

Health & Social Work ◽

10.1093/hsw/29.3.219 ◽

2004 ◽

Vol 29 (3) ◽

pp. 219-244 ◽

Cited By ~ 83

Author(s):

G. Kadushin

Keyword(s):

Health Care ◽

Social Work ◽

Health Care Utilization ◽

Home Health Care ◽

Home Health ◽

Care Utilization

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Relationships Between Race/Ethnicity and Health Care Utilization Among Older Post-Acute Home Health Care Patients

Journal of Applied Gerontology ◽

10.1177/0733464818758453 ◽

2018 ◽

Vol 39 (2) ◽

pp. 201-213 ◽

Cited By ~ 1

Author(s):

Jo-Ana D. Chase ◽

David Russell ◽

Liming Huang ◽

Alexandra Hanlon ◽

Melissa O’Connor ◽

...

Keyword(s):

Health Care ◽

Health Care Utilization ◽

Ethnic Differences ◽

Home Health Care ◽

Service Use ◽

Home Health ◽

Care Utilization ◽

Proactive Management ◽

Race Ethnicity ◽

Racial Ethnic

Few studies have explored racial/ethnic differences in health care outcomes among patients receiving home health care (HHC), despite known differences in other care settings. We conducted a retrospective cohort study examining racial/ethnic disparities in rehospitalization and emergency room (ER) use among post-acute patients served by a large northeastern HHC agency between 2013 and 2014 ( N = 22,722). We used multivariable binomial logistic regression to describe the relationship between race/ethnicity and health care utilization outcomes, adjusting for individual-level factors that are conceptually related to health service use. Overall rates of rehospitalization and ER visits were 10% and 13%, respectively. African American and Hispanic patients experienced higher odds of ER visits or rehospitalization during their HHC episode. Racial/ethnic differences in utilization were mediated by enabling factors, such as caregiver availability, and illness-level factors, such as illness severity, functional status, and symptoms. Intervention targets may include early risk assessment, proactive management of clinical conditions, rehabilitative therapy, and caregiver training.

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