Factors affecting home health agency behavior: an interactionist view

Much attention has been given to developing alternatives to institutionally based long term care. For most of the alternative programs the community agencies are assumed to be the health provider of health and personal care services. An analysis of 18,000 patients discharged from 45 home health agencies in one state reveals that the agencies provide very different patterns of services in terms of skilled and personal care. Agencies also vary widely in the type of person served in terms of disability and reimbursement. It appears that the home health agencies through a process of internal and external interactions establish their role in the long term care delivery system and subsequent referral patterns reflect that role.