Rural, Urban Disparities Seen for Quality of Home Health Care

There are significant and persistent differences in quality of care between rural and urban home health agencies, according to a study published online Jan. 5 in the Journal of Rural Health.

Chenjuan Ma, Ph.D., from New York University Rory Meyers College of Nursing in New York City, and colleagues used data from the 2014 to 2018 national Home Health Compare and Providers of Service Profile to assess disparities in quality performance between rural and urban home health agencies. The analysis included 7,908 home health agencies, of which 1,537 were rural agencies.

The researchers found that rural agencies were less likely to be for-profit and accredited and were more likely to be hospital-based, serve both Medicare and Medicaid beneficiaries, and have hospice programs. There was consistent outperformance by rural agencies on timely initiation of care over time, while urban agencies consistently outperformed on hospitalization and emergency department visits over time. Over time, these gaps between rural and urban agencies were steady, with the exception of the gap in hospitalization, which slightly narrowed.

“Our study highlights the persistence of disparities in quality of home health care,” Ma said in a statement. “Limited improvements have been made in the quality of home health care over time, and the gaps in quality of care did not significantly shrink between rural and urban agencies.”

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