A VNA home health care program: predicting patients who refuse services

Many studies have been compiled which report patient characteristics and patterns in the utilization of health care services. Very little information is available on the characteristics of patients who refuse services in a particular program. This article employs a sample of 246 home health care patients to describe the characteristics of persons refusing services compared to a group "normally" terminating service. The method employed is discriminant analysis. The results of the study are substantively consistent with the theoretical and empirical literature on health care utilization. Those refusing service were less likely to be insured and tended to have multiple admissions to the program. They were less inclined to improve in functional status, despite a tendency toward a longer stay in the program. Curiously, fewer nursing visits occurred for these patients, despite their longer stays. Implications of the study for program management are discussed.