Does the Veterans Health Administration Purchase High-Quality Home Health Care?
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View abstract on PubMed
Summary
This summary is machine-generated.Veterans receive high-quality home health care (HHC) through VA contracts. However, rural Veterans face challenges accessing high-quality agencies compared to urban counterparts, with more neutral quality options available.
Area Of Science
- Health Services Research
- Gerontology
- Public Health Policy
Background
- Veterans often require skilled home health care (HHC) post-hospitalization.
- Access to quality care is crucial for recovery and well-being.
- Disparities in healthcare access may exist based on geographic location.
Purpose Of The Study
- To evaluate the quality of VA-contracted home health agencies (HHAs) for Veterans after hospital discharge.
- To compare access to high-quality HHAs between Veterans in rural and urban areas.
- To assess the quality of VA-contracted HHAs relative to all HHAs available in a county.
Main Methods
- Retrospective observational study using national VA data (April 2015-September 2019).
- Inclusion of Veterans discharged from VA medical centers (VAMCs) receiving VA-paid HHC.
- Calculation of a quality ratio (QR) comparing high-quality (4- or 5-star) VA-contracted HHAs to all high-quality HHAs by county, aggregated by VAMC.
Main Results
- 60,406 HHC episodes for 42,010 Veterans were analyzed across 113 VAMCs.
- While 61.1% of VAMCs had high QRs, only 27.3% serving rural Veterans did.
- Rural Veterans had lower access to high-quality HHAs (46.3%) compared to urban Veterans (64.0%), with a higher proportion of neutral quality HHAs.
Conclusions
- VA-contracted HHAs generally offer higher quality care compared to all available HHAs.
- VAMCs serving rural populations demonstrated less access to high-quality HHAs.
- This disparity is attributed to greater availability of neutral-quality HHAs in rural areas, not preferential contracting with lower-quality agencies.
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