Effect of Neighborhood Disadvantage on Home Health Quality Received by Older Adults: An Integrated Literature Review

More than 3 million Medicare beneficiaries use home healthcare annually. The prevalence of neighborhood disadvantage for community-living older adults is 15.8%. Medicare's Home Health Value-Based Purchasing (HHVBP) model quality measures for home health were initiated in 2016. There is little data on the quality of care received in home health by vulnerable beneficiaries living in disadvantaged neighborhoods. The purpose of this literature review was to analyze the quality of home healthcare (HHC), as determined by the five-star rating system or other quality measures, based on neighborhood socioeconomic disadvantage levels. A literature search of four databases was conducted. Two researchers independently assessed each study for methodological quality using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Eight articles met the inclusion criteria and found that older adults living in lower socioeconomic status neighborhoods receive HHC from agencies that receive lower star ratings and lower quality of care.