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Outcomes in Rural and Urban Home Health Agencies

University of Chicago and the Walsh Center for Rural Health Policy Analysis

This study used Home Health Compare data to determine whether rural and urban home care agencies differ in terms of patient care outcomes. Small differences in the quality of care provided by home health agencies in urban and rural areas were found. Measured in terms of improvement in functional outcomes, differences were generally less than 2 percentage points, and rural agencies' performance was neither consistently better nor consistently worse than that of their urban counterparts. When measured as adverse events, rural and urban differences were not significant. Even though results were statistically significant, this does not imply that they were important or clinically meaningful; rather, results suggest that rural and urban agencies' performance on the set of outcomes measured in this study is relatively comparable. This is an encouraging result given concerns that access to skilled providers (e.g., occupational therapists) is limited in many rural communities. Additional research is needed to identify the factors driving performance in rural home health agencies.

Key Words: rural • urban • Home Health Compare • quality • physical therapy • occupational therapy

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