A comparative analysis of disability measures and their relation to home health care use

This study examines the relationship between various definitions of disability and the use of home health care. Using data from the 1993 Survey of Asset and Health Dynamics among the Oldest Old, four measures of disability are constructed based on the concepts of difficulty and assistance. Logistic regression techniques are used to examine differences across measures in the probability of home health care use for specific subgroups of the older population (e.g., married Black females, unmarried White males). Home health care use was most likely when the presence of both assistance and difficulty were included in the definition of disability. Regardless of the measure used, women, Whites, and unmarried people had higher likelihoods of using home health care than men, Blacks, and married people respectively. If used as a service eligibility criterion, an inclusive measure of disability would result in a large number of potential service users. Efforts to control expenditures through the use of a narrower measure that requires the presence of assistance may disadvantage some subgroups of the older population.