Is there equity in the home health care market? Understanding racial patterns in the use of formal home health care.
OBJECTIVE
This article explores whether the formal home health care (HHC) market is equitable or manifests unexplained racial disparities in use.


METHODS
The database is the 1994 National Long Term Care Survey. We estimate logit regression models with a race dummy variable, race interaction terms, and stratification by race. We apply the Oaxaca decomposition technique to quantify whether the observed racial gap in formal HHC use is explained by racial differences in predisposing, enabling, need, and environmental characteristics.


RESULTS
We find numerous unique racial patterns in HHC use. Blacks with diabetes and low income have higher probabilities of HHC use than their White counterparts. Black older persons have a 25% higher chance of using HHC than Whites. Our Oaxaca analysis indicates that racial differences in predisposing, enabling, need, and environmental characteristics account for the racial gap in use of HHC.


CONCLUSIONS
We find that the HHC market is equitable, enhancing availability, acceptability, and accessibility of care for older Black persons. Thus, the racial differences that we find are not racial disparities.
University of Tennessee Health Science Center, 847 Monroe Avenue, Room 205N, Memphis, TN 38113, USA. kingram.utmem.edu.
Shelley I
SI
White-Means
Rose M
RM
Rubin
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D005006:Ethnicity / Q000706:statistics & numerical data*; D019981:Health Care Sector / Q000592:standards*; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data; D006299:Health Services for the Aged / Q000191:economics / Q000706:statistics & numerical data*; D006304:Health Status; D006699:Home Care Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D015233:Models, Statistical; D012935:Social Justice; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data