NEIGHBORHOOD CHARACTERISTICS AND QUALITY PERFORMANCE OF HOME HEALTH AGENCIES: A COHORT STUDY

Abstract Home health care (HHC) is a core source of home- and community-based services to older adults “aging in place’. This study examined variation HHC quality by neighborhood characteristics the US using 5 years (2014-2019) national Health Compare data linked Providers Services (POS) files Area Resources Files (AHRF). was measured agency rates timely initiation care, hospitalization, ED visits. We 7,487 agencies (37,435 agency-years) 1,760 counties. At baseline, mean visit were 91.5%, 15.8%, 12.5%. On average, county percentage Blacks, Hispanic, individuals with college degree, unemployment, being poverty 12.9% (range: 0.1% – 76.0%), 20.6% (0.4% - 95.8%), 30.4% (7.3% 77.6%), 5.4% (2.1% 24.0%), 14.4% (3.1% 38.0%) respectively 2015. Estimates from multivariate regressions showed that neighborhoods higher proportion Blacks (β= -0.04, p=0.000) Hispanics -0.02, p=0.000), rate unemployment -0.07, p=0.035) less likely have providing initiated care; proportions 0.01, 0.02, p=0.027) more hospitalization rates; 0.04, rates. Our findings indicate racial/ethnic minorities low socioeconomic status highly access high HHC.