Long-term admissions to home health agencies: a life table analysis

This article uses the first national survey of home health agencies and their patients to characterize the complete length-of-use distribution for an elderly admissions cohort. Of the 26 million older Americans admitted to home health agencies in 1992, 36% received care for at least three months, 22% for at least six months, and 15% for at least one year. Analyses suggest that one-year limits on Medicare's home health benefit would have affected a relatively small percentage of new admissions (less than 13%) but would have amounted to 300,000 or so beneficiaries in 1992. In contrast, proposals to limit Medicaid would have affected a more substantial proportion of home health agency admissions (about one fourth) but only a relatively small number of older Americans (30,000 in 1992). Such length of use limits would also disproportionately affect those at highest risk for nursing home admission: very old, unmarried, minority women with relatively unstable chronic conditions.