Rural and urban differentials in Medicare home health use.
Kenney, Genevieve M
Date of Pub
This article addresses whether the use of Medicare home health services differs systematically for rural and urban beneficiaries.
It draws on Medicare data bases from 1983, 1985, and 1987, including the Health Insurance Skeleton Write-Off (HISKEW) files
and the Home Health Agency (HHA) 40-percent Bill Skeleton files. It presents background information on rural and urban beneficiaries
and contrasts the use rates, visit levels and profiles, episodes of home health use, and primary diagnoses in rural and urban
areas. The results point to higher home health use rates in urban areas and to a narrowing of the urban-rural use differential
from 1983 to 1987. Rural home health users receive on average three more visits than their urban counterparts, with many more
skilled nursing and home health aide visits. However, rural enrollees are much less likely than urban enrollees to receive
medical social service or therapeutic visits, even after controlling for primary diagnosis. These findings point to the need
for further analysis to understand the consequences of these differences.
Comparative Study : Data Collection : Diagnosis-Related Groups/statistics & numerical data : Episode of Care : Geography :
Home Care Services/economics/utilization : Human : Medicare/statistics & numerical data/utilization : Rural Health/statistics
& numerical data : United States : Urban Health/statistics & numerical data : Utilization Review/statistics & numerical data