Introduction: Past studies rarely have focused on “the oldest” frail elderly population, and none has examined disparities across different racial/ethnic groups in home care. This study examined the social support structures, service utilization patterns, and physical and mental health outcomes across four racial/ethnic groups receiving home health care. Methods: Outcomes Assessment Information Set (OASIS) records for all 1999 initial home care assessments for patients ≥ 75 years of age who self-identified as White, Black, Hispanic, or Asian (n=20,451) were linked to discharge records to identify patients discharged to self/community care (n=7,208). Descriptive and risk-adjusted multivariate analyses were conducted. Results: Many similarities were found across the racial/ethnic groups, particularly in service utilization, physical functioning, pain levels, and ADL dependencies. However, disparities were present in socioeconomic status, social support and mental health outcomes. As compared to Whites, a greater proportion of racial/ethnic minorities were dually-eligible and resided in lower-income communities. As compared to other racial/ethnic groups, Black elders were more likely to have little or no additional support (paid or unpaid) at entry and discharge. Hispanics were significantly less likely to show improvements in IADL dependency at discharge, as compared to other racial/ethnic groups. However, White elders were more likely than other groups to experience anxiety and depression at discharge. Conclusions: The findings suggest a need for greater mental health services for targeted populations of frail elderly. Formal care providers should increase efforts to address disparities in social support needs through referrals and linkages to supportive services.
Learning Objectives: At the conclusion of the session, the participant will be able to: 1) describe demographic and health status differences across 4 racial/ethnic groups admitted to home care in an urban setting; 2) describe factors associated with improved physical health outcomes for home care patients; and 3) describe factors associated with improved psychological health outcomes for home care patients.
Keywords: Home Care, Minority Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Visiting Nurse Service of New York
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: employment