MedicalResearch.com Interview with:
Karen Joynt Maddox, MD, MPH
Washington University School of Medicine
Saint Louis MO
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Home health is one of the fastest-growing sectors in Medicare, and the setting of a new federal value-based payment program, yet little is known about disparities in clinical outcomes among Medicare beneficiaries receiving home health care.
We found that beneficiaries who were poor or Black had worse clinical outcomes in home health care than their peers. These individuals were generally more likely to have unplanned hospitalizations, readmissions, and emergency department visits. Under Home Health Value-Based Purchasing, these patterns should be tracked carefully to ensure the program helps close the gaps rather than widening them.
MedicalResearch.com: What should readers take away from your report?
Response: Poor individuals and racial minorities have worse clinical outcomes in home health care. Disparities in home health care represent an important target for quality improvement and for improving health equity.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: While this study documented that disparities exist, it doesn’t help us understand why, or what best to do to reduce them. Understanding the cause of these disparities and finding strategies to reduce them are critical next steps for researchers and clinical leaders.
MedicalResearch.com: Is there anything else you would like to add?
Response: Some of the authors are government employees, but the findings do not represent the official position of the U.S. government.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Joynt Maddox, K. E., Chen, L. M., Zuckerman, R. and Epstein, A. M. (2017), Association Between Race, Neighborhood, and Medicaid Enrollment and Outcomes in Medicare Home Health Care. Journal of the American Geriatrics Society. doi: 10.1111/jgs.15082
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