Access To Home Health Care Services

Access to home health care services is a concern for older adults with limited resources. The service providers assessed barriers to health care among an urban, low-income population living independently in a major metropolitan community. People need to evaluate the needs of both the family caregiver and the person for whom home health care will be provided.

People should use a worksheet to create a contract for services, so that it is clear exactly what is expected of the home health care provider. Normally home health caregivers provide four categories of services, like Health Care Services, Emotional Care, Living Independently, and Personal Care Services. Health care services may include managing medications, medical appointments, and physical therapy. Emotional care includes hobbies, meaningful social activities, a creative outlet or simply companionship.

These service providers utilize a random digit dialing telephone survey to assess health status and quality of life among adults 60 years and older. A random sample of many subjects normally represents a population of approximately 15,000 older adults. The survey tool of the home health caregivers consisted of around 115 items including questions regarding health status, access to care, socio-economic status, living conditions, and social support networks. Adult people of around 60 years and older who live independently in one of four zip codes in central city may get the home health care access. The percentage is like 75% female and 88% African-American. The distribution of the age was 60-74 (51%), 75-84 (41%), and > 85 (8%). Sixty-six percent of people lived alone, 35% reported an annual income of < $10,000, and 48% reported less than high school education.

Consistent with the age, 30% of people were reported fair-poor health, and 92% one or more chronic diseases. The home health caregivers assessed the utilization of formal (reimbursed) home services. Utilization of home health care services was correlated with physical health status and with days per annum that the person was confined to bed. For the people, however, whose physical health status was in the lowest quartile, 63% utilized no home healthcare services. In addition to this among people reporting 5 or more bed days during the past year, 59.8% did actually not have access to home healthcare services.

People who experienced a recent acute illness including hospitalization, critical care, emergency room visit, or confinement to bed for more than 4 days were less likely to utilize short term assistance than people without acute health needs. Forty-three percent of people reported serious limitations with mobility. Among respondents with acute immobility, 76% utilized some form of paid home health services or chore services. People with severe restrictions of mobility were less likely to utilize chore services than people with greater mobility. A contributing factor to limited exploitation of services was lack of knowledge regarding home health care services. Fifteen percent of respondents with restricted mobility had never heard of chore home health care services.

These results actually highlight a difference between utilization of home health services and the apparent need for services among an urban, low-income population. As urban hospitals are bound to reduce home health care services that sustain urban poor during acute illnesses and convalescence, it is important to assure that support services are accessible to those who most need resources, and that those in need of services are expeditiously identified and linked with providers of those services.

• Emma Bullock
• 14/01/2009, 8:59 AM
• 0 Comments