GSA Study: Increased Access to Home Health Improves Patient Outcomes

Researchers call on Congress to support Preserving Access to Home Health Act

A recent study published by the Gerontological Society of America (GSA) explored the impact of home health care on place of death among Medicare beneficiaries. The researchers aimed to determine if home health care use in the last three years of life could reduce the likelihood of inpatient death without hospice, an outcome many patients and families prefer to avoid, according to previous studies. The GSA study found that the use of home health care during the last three years of life is associated with a lower likelihood that patients would pass away in an inpatient unit and a higher likelihood they would pass away in-home under hospice care. This research illustrates that increased access to home health care for older adults could significantly improve patient outcomes.

GSA’s researchers performed multinomial logistic regression analyses on outcomes data from over two million Medicare beneficiaries who passed away in 2019, focusing on whether they received home health care services in their final years and the timing of that care. Findings include:

• Patients who received any home health care during the last three years of their life had an 8.2% lower chance of passing away in a hospital inpatient unit (23.3% with vs 31.5% without).
• Individuals who began receiving home health care prior to the last year of their life were especially unlikely to pass away in an inpatient unit.
• Use of home health care beginning at any point in the three years prior to death was found to improve probability of at-home versus inpatient death (with hospice) by 9.5% (46.0% with vs 36.5% without).
• Dementia patients included in the study who began home health care at least one year prior to death had the highest possibility of in-home death with hospice (55.6%).

These data points underscore the importance of expanding access to home health services, particularly for dementia patients, as a means of improving the quality of end-of-life care. The researchers conclude by stating:

“Clinical and policy implications include the need to preserve and improve access to home health care, including to maintain a patient’s current condition or prevent or slow further deterioration such as recent bipartisan proposal to ensure stability of Medicare payments for home health care under the ‘Preserving Access to Home Health Act of 2023’ (S.2137/ H.R.5159).”

This report underscores the importance of Congress acting this year to prevent any future cuts to the Medicare home health program.

To download the GSA study, click here.