Nearly half of Medicare patients do not receive recommended home health care after hospitalization, according to a new study published in JAMA Network Open.

Home health care is a rapidly growing service used by patients following hospital stays. In the United States, this is when patients receive health and social services within their home to recover from an injury or illness. Home health care also helps patients maintain independence and has important implications for the US health care system, according to the study.

The study looked at national data on home health care trends between October 2015 and September 2016, before the Affordable Care Act was enacted. Investigators from Syracuse University used data to look at the variation in rates of successful home health care referrals by Medicare patients broken down by sociodemographic characteristics.  

Investigators found that only 54% of Medicare patients who were referred to home health care services following hospitalization received them. Racial and economic gaps were also found. 

Black patients had a 7.3% lower rate of receiving home health care services than white patients. For Hispanic patients, there was a 9.2% gap. Patients living in zip codes with high unemployment and poverty rates had approximately 5% lower rates of receiving home health care services.

"Recent health care reform efforts increasingly rely on home health care as a substitute for institutional care…With this knowledge, policymakers should implement a system that ensures all patients receive the home health care that has been recommended by their physicians," Jun Li, PhD, assistant professor of Public Administration and International Affairs at the Syracuse University Maxwell School of Citizenship and Public Affairs, said in the press release. 

The findings from the study suggest that vulnerable populations face barriers when trying to access home health care services, which contribute to inequality in the US health care system, according to the authors. 

Reference:
Half of Medicare patients do not receive recommended health care after hospitalization [news release]. Syracuse, NY: EurekAlert!; September 2, 2020. https://www.eurekalert.org/pub_releases/2020-09/su-hom090220.php. Accessed September 3, 2020.