Assessment of Disparity in Home Health Services among Medicaid Elder Recipients

Background: In the evolution of the Medicaid program, Medicaid pays for a comprehensive range of home and community base services (HCBS). These services provide alternatives for low-income elderly to live independently in the community as opposed to unnecessary institutional care. The Medicaid services reach a diverse low-income population. To improve this support system and reduce disparity, greater awareness of cultural dimensions needs to be examined in client enrollment and service provision.

Objective: To determine if there are national socio economic disparities in access to HCBS among Medicaid elders.

Methods: Using national data from the 2004 Medical Expenditure Panel Survey, we are examining the correlation between socio economic indicators (SES) and the receipt of a HCBS for elders. This examination uses indicators for age, gender, race, income, education, family size, metropolitan statisical area, and perceived health and mental health status. A Logistic regression model adjusting for the complex survey design is used to examine the association between SES and access to HCBS among Medicaid elders.

Principal Findings: There are significant associations among socio economic indicators and access to HCBS.

Conclusions: The researchers believe that there are significant differences among low-income elder with regard to SES and their utilization of Medicaid HCBS. Future research might examine the further roles of cultural sensitivity in both enrollment and provision of HCBS to diverse populations.