Ma C, Dutton HJ & Wu B

Home Health Care Serv Q. Jan- Mar;42(1):1-13.

2023

Home care

Home Care (OME)

Not applicable

No

To depict characteristics of home health agencies (HHAs) with and without accreditation and to examine the relationship between accreditation status and HHA performance on quality-of-care metrics.

Longitudinal Studies, Cohort Study

A longitudinal cohort study using five years (2015–2019) of data from two national sources in the US: the Centers for Medicare and Medicaid Services (CMS) Home Health Compare Program and Providers of Services file (POS) (Home Health Star Ratings. This study analyzed 7,697 agencies. A home health agency was included if it had 1) five years of data (2015–2019) for at least one of the three quality of care measures of interest in the Home Health Compare dataset, timely initiation of care, hospitalization rate, and emergency department visit rate; 2) complete information of accreditation status for each of the 5 years in the POS dataset; and 3) complete organizational characteristics at baseline year (2015) in the POS dataset. The unit of analysis was the home health agency. Descriptive analysis was performed to describe baseline characteristics of the HHAs, including accreditation status; differences in home health agency characteristics by accreditation status at baseline year, followed by a description of agencies’ changes in accreditation status over time. The quality-of-care measures (timely start of care rate, hospitalization rate, and ED visit rate) by accreditation status and other agency characteristics were also described. Graphs were used to visually present trends in quality of home health care over time by agency accreditation status. To understand the relationship of quality of care with agency accreditation status (Model 1) and changes in accreditation status (Model 2), the authors employed generalized linear regression when controlling for agency characteristics and considering clustering of repeated measures within each agency. All statistical analyses were performed using StataSE version 17.0 (StataCorp LP) with an established alpha level of .05.

The results showed: 1) agencies that were for-profit, urban, not-hospital-affiliated, single-branch, Medicare enrolled only, and without hospice program were more likely to have accreditation; and 2) overall, accredited agencies performed better on the three commonly used quality indicators, timely initiation of care, hospitalization, and emergency department visit.

2015-2019

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9901214/

home health; accreditation; hospitalization; patient outcomes; quality of care

Positive