Systematic Review of Racial/Ethnic Outcome Disparities in Home Health Care

Narayan, Mary Curry; Scafide, Katherine N.

doi:10.1177/1043659617700710

Cited by 32 publications

(27 citation statements)

References 15 publications

(41 reference statements)

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“…Existing evidence points to the risk that racial and ethnic minorities in HHC already have for more adverse events, less improvement in functional outcomes, and worse patient experiences when compared with majority patients. 11 This study adds to this body of literature by demonstrating that patients with LEP are also experiencing disparities and risks in their MM. One possible way to address these disparities is through the implementation of cultural and linguistic appropriate services (California Learning Assessment System [CLAS]) to improve care management and outcomes.…”

Section: Discussionmentioning

confidence: 74%

Detecting Disparities in Medication Management Among Limited English Proficient and English Proficient Home Health Patients

Miner

Squires²,

Ma³

et al. 2019

Home Health Care Management & Practice

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According to the U.S. census Bureau, close to 20% of the U.S. population speaks a language other than English at home. Home health care (HHC) patients who speak English less than very well or have limited English proficiency (LEP) are at an increased risk for medication mismanagement and serious health consequences. The purpose of this study was to examine if there were differences in medication management between English-speaking patients and patients with LEP receiving HHC services. Data for this cross-sectional observation study were collected from 2010 to 2014. Medication management was measured by two items in the Centers for Medicare and Medicaid Services–mandated Outcomes Assessment Information Set (OASIS). All patients in the database who were taking medications and had a valid admission and discharge assessment from HHC were included in the analysis. Inverse probability of treatment weighting (IPTW) with a marginal structural model was used to address potential imbalances in observed patient characteristics when estimating the effect of having LEP or being an English-speaking HHC patient on changes in medication management over the course of a HHC episode. Estimates from marginal structural model with inverse probability weighting indicate that being LEP was associated with less improvement in medication management and increased likelihood of getting worse over the course of a HHC episode. This study is one of the first to demonstrate that patients with LEP experience disparities in medication management when compared to English-speaking patients in HHC.

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Section: Discussionmentioning

confidence: 74%

Detecting Disparities in Medication Management Among Limited English Proficient and English Proficient Home Health Patients

Miner

Squires²,

Ma³

et al. 2019

Home Health Care Management & Practice

View full text Add to dashboard Cite

show abstract

“…Disparities occur in home health care. For instance, Narayan and Scafide 17 performed a systemic review of home healthcare outcomes for the federally defined race/ethnicity groups, published between 2003 and 2015. Although they only found seven studies that met their criteria, all seven studies found that racial/ethnic minority patients suffered disparate outcomes in comparison to their non-Hispanic White counterparts.…”

Section: Home Healthcare Disparitiesmentioning

confidence: 99%

Cultural Competence in Home Healthcare Nursing: Disparity, Cost, Regulatory, Accreditation, Ethical, and Practice Issues

Narayan

2019

Home Health Care Management & Practice

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Home healthcare patients, who are members of minority, marginalized, or vulnerable patient populations, are at risk for healthcare disparities. Inadequate attention to the needs of the many different types of diverse patient populations seen by home health agencies could compromise an agency’s outcome indicators, reimbursement in value-based payment programs and responsibility to deliver equitable quality care. Culturally competent home health nurses may have a role in decreasing disparities and improving patient outcomes. This article discusses the incidence of disparities in home health care and highlights literature about the economic, regulatory, accrediting, policy, social justice, and ethical issues surrounding disparate and inequitable care for home healthcare patients. Patients in need of culturally competent care include those characterized by diversity related to race, ethnicity, language, religion, socioeconomic status, sexual orientation, gender identification, mental and physical disabilities, and stigmatized diagnoses (e.g., obesity and substance abuse). Home healthcare nurses who strengthen the cultural competence of their care may be able to decrease the incidence of disparate outcomes. By investing in the cultural competence of their home healthcare nurses, agencies may strengthen their commitment to their missions and the financial health of their agencies.

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“…Because scholarship has tended to address either ethnic or religious diversity with little consideration of their intersection, the review that follows also addresses religious and ethnic diversity in home health separately. Literature related to ethnic diversity in home health (without explicit attention to religion or spirituality) shows evidence of inequalities in service provision along lines of culture, ethnicity, gender, material resources, geographic location, and language (Davitt, Bourjolly, & Frasso, 2015;Giesbrecht et al, 2012;Narayan & Scafide, 2017;Peckover & Chidlaw, 2007;Smith et al, 2015). For example, in a recent systematic review of racial/ethnic outcome disparities in home health care, Narayan and Scafide (2017) found strong though limited evidence of disparities for minority patients on health outcomes (e.g., less improvement in mobility and dyspnea, higher likelihood of hospitalization, higher risk of an adverse event, and less satisfied with care).…”

Section: Religious and Ethnic Diversity In Home Healthmentioning

confidence: 99%

“…Literature related to ethnic diversity in home health (without explicit attention to religion or spirituality) shows evidence of inequalities in service provision along lines of culture, ethnicity, gender, material resources, geographic location, and language (Davitt, Bourjolly, & Frasso, 2015;Giesbrecht et al, 2012;Narayan & Scafide, 2017;Peckover & Chidlaw, 2007;Smith et al, 2015). For example, in a recent systematic review of racial/ethnic outcome disparities in home health care, Narayan and Scafide (2017) found strong though limited evidence of disparities for minority patients on health outcomes (e.g., less improvement in mobility and dyspnea, higher likelihood of hospitalization, higher risk of an adverse event, and less satisfied with care). In the U.S., Davitt, Bourjolly, and Frasso (2015) conducted focus groups with Black, Hispanic, and White home health care staff to glean their perspectives on contributing factors to racial and ethnic disparities in home health care outcomes.…”

Section: Religious and Ethnic Diversity In Home Healthmentioning

confidence: 99%

‘The Elephant on the Table’: Religious and Ethnic Diversity in Home Health Services

et al. 2017

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Healthcare services are increasingly being provided in the home. At the same time, these home contexts are changing as global migration has brought unprecedented diversity both in the recipients of care, and home health workers. In this paper, we present findings of a Canadian study that examined the negotiation of religious and ethnic plurality in home health. Qualitative analysis of the data from interviews and observations with participants-clients, administrators, home healthcare workers-revealed how religion is expressed and 'managed' in home health services

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Systematic Review of Racial/Ethnic Outcome Disparities in Home Health Care

Abstract: Home health care disparities exist and efforts should be made to provide culturally and linguistically appropriate care to all patients.

Cited by 32 publications

References 15 publications

Detecting Disparities in Medication Management Among Limited English Proficient and English Proficient Home Health Patients

Detecting Disparities in Medication Management Among Limited English Proficient and English Proficient Home Health Patients

Cultural Competence in Home Healthcare Nursing: Disparity, Cost, Regulatory, Accreditation, Ethical, and Practice Issues

‘The Elephant on the Table’: Religious and Ethnic Diversity in Home Health Services

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