Rural and urban disparities in quality of home health care : A longitudinal cohort study (2014-2018)
© 2022 National Rural Health Association..
PURPOSE: Home health care is one of the fastest growing health care sectors in the United States. However, little is known of differences in trends in quality performance between rural and urban home health agencies over time. This study aimed to examine disparities in quality performance between rural and urban home health agencies between 2014 and 2018.
METHODS: This is a cohort study using 2014-2018 national Home Health Compare data and Providers of Service Profile data, including 7,908 home health agencies, of which 1,537 were rural agencies. Quality performance measures included timely initiation of care, hospitalization, and emergency department (ED) visits. Two-level hierarchical regression models were used to identify rural-urban differences in these quality indicators over time when controlling organizational characteristics.
FINDINGS: Rural agencies were less likely to be for-profit and accredited, and more likely to be hospital-based, serve both Medicare and Medicaid beneficiaries, and have hospice programs. Rural agencies consistently outperformed on timely initiation of care over time, and urban agencies consistently outperformed on hospitalization and ED visits over time. These gaps between rural and urban agencies were steady over time except the gap in hospitalization, which slightly narrowed over time (Coef. = 0.11, P = .001 for urban and year interaction term).
CONCLUSIONS: Significant differences exist in quality of care between rural and urban home health agencies and such differences have not been significantly narrowed over time. To reduce rural-urban disparities, policy makers should take into account unique challenges faced by urban and rural agencies when making policy decisions.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
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| Enthalten in: |
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association - 38(2022), 4 vom: 07. Sept., Seite 705-712 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ma, Chenjuan [VerfasserIn] |
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| Links: |
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| Themen: |
Health disparities |
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| Anmerkungen: |
Date Completed 23.09.2022 Date Revised 03.10.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/jrh.12642 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM335216617 |
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| 100 | 1 | |a Ma, Chenjuan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Rural and urban disparities in quality of home health care |b A longitudinal cohort study (2014-2018) |
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| 500 | |a Date Revised 03.10.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022 National Rural Health Association. | ||
| 520 | |a PURPOSE: Home health care is one of the fastest growing health care sectors in the United States. However, little is known of differences in trends in quality performance between rural and urban home health agencies over time. This study aimed to examine disparities in quality performance between rural and urban home health agencies between 2014 and 2018 | ||
| 520 | |a METHODS: This is a cohort study using 2014-2018 national Home Health Compare data and Providers of Service Profile data, including 7,908 home health agencies, of which 1,537 were rural agencies. Quality performance measures included timely initiation of care, hospitalization, and emergency department (ED) visits. Two-level hierarchical regression models were used to identify rural-urban differences in these quality indicators over time when controlling organizational characteristics | ||
| 520 | |a FINDINGS: Rural agencies were less likely to be for-profit and accredited, and more likely to be hospital-based, serve both Medicare and Medicaid beneficiaries, and have hospice programs. Rural agencies consistently outperformed on timely initiation of care over time, and urban agencies consistently outperformed on hospitalization and ED visits over time. These gaps between rural and urban agencies were steady over time except the gap in hospitalization, which slightly narrowed over time (Coef. = 0.11, P = .001 for urban and year interaction term) | ||
| 520 | |a CONCLUSIONS: Significant differences exist in quality of care between rural and urban home health agencies and such differences have not been significantly narrowed over time. To reduce rural-urban disparities, policy makers should take into account unique challenges faced by urban and rural agencies when making policy decisions | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a health disparities | |
| 650 | 4 | |a home health care | |
| 650 | 4 | |a quality of care | |
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| 650 | 4 | |a urban health | |
| 700 | 1 | |a Devoti, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a O'Connor, Melissa |e verfasserin |4 aut | |
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