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)

Abstract

AbstractINTRODUCTIONWe 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).METHODSMedicare 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.RESULTSOf 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.DISCUSSIONBlack patients are more likely to experience a delay in home health care initiation than White patients.