Variability in average length of stay in home health care has important implications for addressing inequality and inefficiency in the delivery of such services. This paper examines variation in length of stay patterns in home health care agencies by examining the influence of organizational form, controlling for client characteristics. Organizational behavior theory suggests that organizational characteristics can be investigated to determine differences in organizational behavior. Three theories (resource dependency, insititutional theory and population ecology) were used to examine the patterns of variability found in the average length of stay in US home health care agencies. Data are from the 1992 National Home Health and Hospice Care Survey (NHHCS). Random intercept linear regression models using HLM were developed to assess the effects of organizational form on average length of stay. Approximately 19% of the total variance in average length of stay is associated with factors at the agency level. In random intercepts models that control for client characteristics, it was found that 29% of variance could be explained by agency level variables and being chain affiliated was marginally associated with reduced average length of stay in home health care. Policy changes and current reform must consider the impact on home care service provision because organizational arrangements may result in differential responses which may have unintended consequences for a number of stakeholders in the industry (e.g. clients, providers, administrators, government).
Learning Objectives: At the conclusion of this paper, the participant in this session will be able to: 1. Identify organizational characteristics that account for variation in average length of stay in home health care 2. Recognize the value of studying home health care from an organizational behavior perspective 3. Discuss the impact of public policy change on the home health care industry in terms of its implications for equity and efficiency
Keywords: Home Care, Utilization
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.