title: Racial and Ethnic Disparities in Patients' Experience With Skilled Home Health Care Services.
abstract: Racial and ethnic disparities are found in many health care settings; however, there is little prior research on such disparities among patients receiving home health care services. This study used 2012 Home Health Care CAHPS(®) data to identify any overall patient-level disparities in self-reported experience of care and to decompose these disparities according to whether they result from within-agency versus between-agency differences. Although patient experience of care ratings were high across all groups, the study identified consistently lower ratings for all minority groups on two of three Home Health Care CAHPS measures, with Asians reporting the greatest disparities. Three quarters of disparities were found to be within-agency disparities, which were primarily related to care processes and provider/patient communications rather than to specific health care services received. Despite high ratings in general, home health agencies may need to focus on cultural competency initiatives to address racial and ethnic disparities within their agencies.
authors.affiliation: RTI International, Waltham, MA, USA lsmith@rti.org.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Smith
authors.affiliation: RTI International, Research Triangle Park, NC, USA.
authors.forename: Wayne L
authors.initials: WL
authors.lastname: Anderson
authors.affiliation: RTI International, Research Triangle Park, NC, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Kenyon
authors.affiliation: RTI International, Research Triangle Park, NC, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kinyara
authors.affiliation: RTI International, Research Triangle Park, NC, USA.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: With
authors.affiliation: Centers for Medicare & Medicaid Services, Baltimore, MD, USA.
authors.forename: Lori
authors.initials: L
authors.lastname: Teichman
authors.affiliation: Centers for Medicare & Medicaid Services, Baltimore, MD, USA.
authors.forename: Debra
authors.initials: D
authors.lastname: Dean-Whittaker
authors.affiliation: Centers for Medicare & Medicaid Services, Baltimore, MD, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Goldstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005006:Ethnicity; D005260:Female; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000208:ethnology*; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000208:ethnology*; D044469:Racial Groups; D055815:Young Adult
keywords: HHCAHPS; disparities; home health care; patient experience; patient satisfaction