Out Of Reach: Inequities In The Use Of High-Quality Home Health Agencies

Shekinah A. Fashaw-Walters, Momotazur Rahman, Gilbert Gee, Vincent Mor, Michael White, Kali S. Thomas

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Patients receiving home health services from high-quality home health agencies often experience fewer adverse outcomes (for example, hospitalizations) than patients receiving services from low-quality agencies. Using administrative data from 2016 and regression analysis, we examined individual-and neighborhood-level racial, ethnic, and socioeconomic factors associated with the use of high-quality home health agencies. We found that Black and Hispanic home health patients had a 2.2-percentage-point and a 2.5-percentage-point lower adjusted probability of high-quality agency use, respectively, compared with their White counterparts within the same neighborhoods. Low-income patients had a 1.2-percentage-point lower adjusted probability of high-quality agency use compared with their higher-income counterparts, whereas home health patients residing in neighborhoods with higher proportions of marginalized residents had a lower adjusted probability of high-quality agency use. Some 40–77 percent of the disparities in high-quality agency use were attributable to neighborhood-level factors. Ameliorating these inequities will require policies that dismantle structural and institutional barriers related to residential segregation.

Original languageEnglish (US)
Pages (from-to)247-255
Number of pages9
JournalHealth Affairs
Issue number2
StatePublished - Feb 2022

Bibliographical note

Publisher Copyright:
© 2022, Project HOPE. All rights reserved.

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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