Quality of home health care differs in rural vs. urban settings

Home health care—in which health care providers, primarily nurses, visit patients’ homes to deliver care—is one of the fastest growing health care sectors in the United States. In 2018, more than 5 million Medicare beneficiaries received home health care; 9 percent of patients lived in rural areas.

As the use of home health care increases across the country, researchers are working to better understand how quality varies and whether there are disparities in care based on location.

To understand differences between quality in urban and rural home health care, the researchers analyzed national data on home health quality performance measures from the Centers for Medicare and Medicaid Services over five years (2014 to 2018).

Their data included 7,908 home health agencies, of which nearly 20 percent (1,537) were in rural areas. Quality performance measures included timely initiation of care (a measure of care process), and hospitalization and emergency department visits (two measures of care outcomes).

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