Funding a Health Disparities Research Agenda: The Case of Medicare Home Health Care

Systematic Review of Racial/Ethnic Outcome Disparities in Home Health Care

“…The two other studies investigating functional outcomes (AHRQ, 2014a; Davitt, 2014) also found disparities in functional status. The four studies investigating adverse events (Davitt, 2014;Fortinsky et al, 2014;Madigan, 2007;Ryvicker et al, 2012) found minority patients, particularly Black patients (Fortinsky et al, 2014), were more likely to be hospitalized during the course of home health care. Smith et al (2015) found that minority patients, especially Asian patients, report less satisfaction with the courtesy, communication, and care they received during their stay in home health care compared with White patients.…”

“…Table 3 provides a detailed summary of each included study. Only four studies (AHRQ, 2014a; Brega et al, 2005; Davitt, 2014; Smith et al, 2015) focused their research question specifically on identifying disparities in home health care outcomes based on race/ethnicity. The other three studies in the review sought to identify predictors of adverse events, especially hospitalization during home health care services (Fortinsky et al, 2014; Madigan, 2007; Ryvicker et al, 2012).…”

“…Most efforts to alleviate racial and ethnic disparities seem to have taken place in primary and acute care settings (Davitt, 2014), leaving knowledge about the prevalence, impact, and prevention of disparities in home health care still in its infancy (Davitt, 2012). For example, there is little evidence that home health care agencies either individually or as an industry have incorporated the CLAS Standards into their practices (Narayan, 2002(Narayan, , 2017.…”

“…Another study was added late in the review process during our review of the literature. An article by Davitt (2014), which had been excluded during the title/abstract screening, had an original study embedded in its discussion of funding priorities for home health care disparities research. Having met our inclusion/exclusion criteria, this study was also included.…”

Cultural Competence in Home Healthcare Nursing: Disparity, Cost, Regulatory, Accreditation, Ethical, and Practice Issues

“…Brega and colleagues 18 found that minority groups had significantly inferior functional outcomes compared to non-Hispanic White patients. In a secondary analysis of Outcomes and Assessment Information Set ( OASIS ) data, Davitt 19 found that minority patients’ functional outcomes deteriorated in home health care. Madigan, 20 Ryvicker et al, 21 and Fortinsky et al 22 found that non-White patients were more likely to experience adverse events, such as hospitalization or emergency department visits.…”