Agency ownership, patient payment source, and length of service in home care, 1992 2000.
OBJECTIVE
Little is known about whether an association exists between agency ownership and length of service among home care patients with different payment sources. This study investigated how for-profit and not-for-profit agencies responded to policy changes in the 1990s with respect to length of service.


METHODS
We examined length of service among 37,364 home care patients using the 1992, 1994, 1996, 1998, and 2000 National Home and Hospice Care Surveys. We used Kaplan-Meier methods and Cox regression models.


RESULTS
After we adjusted for patient and agency characteristics, our results revealed that agency ownership was not associated with length of service for patients with private insurance, Medicare, Medicaid, Medicare plus Medicaid, or Medicare plus private insurance. This finding was consistent from 1992 through 2000. Length of service among patients with Medicare decreased significantly from 1998 through 2000, but length of service among patients with Medicaid did not change significantly from 1992 through 2000.


CONCLUSIONS
Agency ownership is not associated with patient length of service in home care. Regardless of the policy changes in the home care arena in the 1990s, for-profit and not-for-profit home health agencies behaved similarly with regard to length of service among patients within differently structured payment systems.
Han
Beth
B
US Department of Health and Human SErvices, Washington, DC, USA. beth.han@samhsa.hhs.gov
McAuley
William J
WJ
Remsburg
Robin E
RE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019538:Health Care Surveys; D006269:Health Facilities, Proprietary / Q000191:economics / Q000706:statistics & numerical data; D018574:Home Care Agencies / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data*; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D009939:Organizations, Nonprofit / Q000191:economics / Q000706:statistics & numerical data; D010067:Ownership; D016016:Proportional Hazards Models; D014481:United States