Examining the role of race and quality of home health agencies in delayed initiation of home health services for individuals with Alzheimer's disease and related dementias (ADRD)

Alzheimers Dement. 2023 Sep;19(9):4037-4045. doi: 10.1002/alz.13139. Epub 2023 May 19.

Abstract

Introduction: We examined differences in the timeliness of the initiation of home health care by race and the quality of home health agencies (HHA) among patients with Alzheimer's disease and related dementias (ADRD).

Methods: Medicare claims and home health assessment data were used for the study cohort: individuals aged ≥65 years with ADRD, and discharged from the hospital. Home health latency was defined as patients receiving home health care after 2 days following hospital discharge.

Results: Of 251,887 patients with ADRD, 57% received home health within 2 days following hospital discharge. Black patients were significantly more likely to experience home health latency (odds ratio [OR] = 1.15, 95% confidence interval [CI] = 1.11-1.19) compared to White patients. Home health latency was significantly higher for Black patients in low-rating HHA (OR = 1.29, 95% CI = 1.22-1.37) compared to White patients in high-rating HHA.

Discussion: Black patients are more likely to experience a delay in home health care initiation than White patients.

Keywords: Alzheimer's disease and related dementias (ADRD); disparities; home health services; process of care; quality of care.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Alzheimer Disease* / therapy
  • Health Services
  • Home Care Agencies*
  • Home Care Services*
  • Humans
  • Medicare
  • United States