A comparative analysis of agencies providing home health services

This study analyzed hospital-based and community-based home health care agencies by means of a small purposive comparative case analysis. The results revealed that hospital-based agencies were different from community-based agencies in terms of agency organization, management, personnel, revenues and expenditures. The voluntary community-based agencies examined were free-standing, single purpose agencies providing the lion's share of direct services to the home health care population. The hospital-based agencies (and public community-based agencies) examined were components of larger organizational structures. Hospital-based agencies concentrate their activities on case finding, case management, and the coordination of patient services, as well as the direct provision of medical therapy and social services. The type of home health agency, community-based or hospital-based, or those examined has been found to define this agency's primary function. This also determined its personnel/staffing pattern and consequently, to a large extent, its expenditure pattern. Additionally, most revenues for certified home health agencies are derived from cost-based reimbursement methodologies of public funding sources. Therefore, agency surpluses or shortages are primarily associated with personnel expenditures and therefore with agency mission and agency type. This study concludes with a discussion of some trends and events that are likely to affect the home health care agencies of the future.