Home Health Care Agency Staffing Patterns before and after the Balanced Budget Act of 1997, by Rural and Urban Location

Autor/inn/en	McAuley, William J.; Spector, William; Van Nostrand, Joan
Titel	Home Health Care Agency Staffing Patterns before and after the Balanced Budget Act of 1997, by Rural and Urban Location
Quelle	In: Journal of Rural Health, 24 (2008) 1, S.12-23 (12 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-765X
DOI	10.1111/j.1748-0361.2008.00132.x
Schlagwörter	Home Health Aides; Counties; Federal Programs; Federal Legislation; Rural Urban Differences; Access to Health Care; Homebound; Allied Health Personnel; Health Needs; Health Services; Rural Areas; Labor Supply; Federal Aid; Statistical Analysis + Suchen Sie Ihr Suchwort? Hauswirtschaftstechnischer Helfer; Bundesrecht; Stadt-Land-Beziehung; Health service; Gesundheitsdienst; Gesundheitswesen; Rural area; Ländlicher Raum; Labour Supply; Arbeitskräfteangebot; Statistische Analyse
Abstract	Context: The Balanced Budget Act (BBA) of 1997 and other recent policies have led to reduced Medicare funding for home health agencies (HHAs) and visits per beneficiary. Purpose: We examine the staffing characteristics of stable Medicare-certified HHAs across rural and urban counties from 1996 to 2002, a period encompassing the changes associated with the BBA and related policies. Methods: Data were drawn from Medicare Provider of Service files and the Area Resource File. The unit of analysis was the 3,126 counties in the United States, grouped into 5 categories: metropolitan, nonmetropolitan adjacent, and 3 nonmetropolitan nonadjacent groups identified by largest town size. Only relatively stable HHAs were included. We generated summary HHA staff statistics for each county group and year. Findings: All staff categories, other than therapists, declined from 1997 to 2002 across the metropolitan and nonmetropolitan county groupings. There were substantial population-adjusted decreases in stable HHA-based home health aides in all counties, including remote counties. Conclusions: The limited presence of stable HHA staff in certain nonmetropolitan county types has been exacerbated since implementation of the BBA, especially in the most rural counties. The loss of aides in more rural counties may limit the availability of home-based long-term care in these locations, where the need for long-term care is considerable. Future research should examine the degree to which the presence of HHA staff influences actual access and whether other paid and unpaid sources of care substitute for Medicare home health care in counties with limited supplies of HHA staff. (Author).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10