Potentially More Out of Reach: Public Reporting Exacerbates Inequities in Home Health Access

作者：Shekinah Fashaw‐Walters, Momotazur Rahman, Gilbert C. Gee, Vincent Mor, Maricruz Rivera‐Hernandez, CERON FORD, Kali S. Thomas · 发表于：Milbank Quarterly · 年份：2023 · DOI：10.1111/1468-0009.12616 · 被引用次数：20 · 研究领域：Patient Satisfaction in Healthcare、Geriatric Care and Nursing Homes、Health disparities and outcomes

Policy Points Public reporting is associated with both mitigating and exacerbating inequities in high-quality home health agency use for marginalized groups. Ensuring equitable access to home health requires taking a closer look at potentially inequitable policies to ensure that these policies are not inadvertently exacerbating disparities as home health public reporting potentially does. Targeted federal, state, and local interventions should focus on raising awareness about the five-star quality ratings among marginalized populations for whom inequities have been exacerbated. CONTEXT: Literature suggests that public reporting of quality may have the unintended consequence of exacerbating disparities in access to high-quality, long-term care for older adults. The objective of this study is to evaluate the impact of the home health five-star ratings on changes in high-quality home health agency use by race, ethnicity, income status, and place-based factors. METHODS: We use data from the Outcome and Assessment Information Set, Medicare Enrollment Files, Care Compare, and American Community Survey to estimate differential access to high-quality home health agencies between July 2014 and June 2017. To estimate the impact of the home health five-star rating introduction on the use of high-quality home health agencies, we use a longitudinal observational pretest-posttest design. FINDINGS: After the introduction of the home health five-star ratings in 2016, we found that adjusted r...