Racial and Ethnic Disparities in Accessing High-Quality Home Health Care among Older Adults with and Without Dementia.
Chenjuan Ma, Bei Wu, Abraham A Brody
PMID 40058763WHAT IT FOUND
Non-Hispanic Black and Hispanic older adults and people with dementia were less likely to receive home health care from high-quality agencies.
Dementia widened these gaps, and minority patients were more often in low-quality agencies.
Key findings
01Racial and ethnic minority groups were more likely than White groups to receive care from low-quality agencies, whether or not dementia was present.
02Non-Hispanic Black and Hispanic older adults were less likely than non-Hispanic White older adults to receive home health care from high-quality agencies.
03People living with dementia were less likely to receive care from high-quality agencies, and dementia widened the racial and ethnic access gaps.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is cross-sectional, so it shows associations between race, ethnicity, dementia, and agency quality, not causes. Dementia was identified from Medicare administrative records, which may miss people with underdiagnosed dementia. Some patient characteristics, such as education and dementia severity or stage, were not available. Agencies without a star rating for overall care quality were excluded, so findings may not apply to those agencies or their patients. The data are from 2016 and may not reflect current home health care, especially after the pandemic. The main outcome was an agency-level star rating, not direct measures of the care each patient received or patient outcomes.
Declared interests
The authors declared no conflicts of interest. The supplied text does not name a specific funder, although the article is tagged as NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not read these findings as proof that race, ethnicity, or dementia caused worse home health care. The study is cross-sectional and reports associations, and the outcome was agency quality, not individual patient outcomes.