home health care government business loan

1994; Mayo et al. 2000; Hansen, Spedtsberg, and Schroll 1992; Stuck et al.

2002. In addition, patients usually prefer home health care over inpatient or skilled nursing care as long as the home care services can meet their needs Cummings et al.

1990; Hughes et al. 1992.

Despite these important advantages, several studies have shown that access to home health visits has not been uniform. e exhibits a U-shaped relationship with home health care, with higher usage among the poorest and wealthiest Kemper 1992; Logan and Spitze 1994; Stoller and Curler 1993; Coughlin et al.

1992; Stum, Bauer, and Delaney 1996; Liu, Manton, and Aragon 2000. Results with respect to Medicaid status have been mixed, with Kemper 1992 showing no relationship and Coughlin et al.

1992 finding Medicaid eligibility improves access to home health care. Education also appears to be related to access, with lower educated seniors less likely to use paid care at home and more likely to report unmet need with respect to home health use following hospital discharge Solomon et al.

1993; Bowles, Naylor, and Foust 2002. With respect to device use, far fewer studies have considered economic resources.

The few studies that have considered such information generally fail to show a relationship between e and device use Norburn et al. 1995; Zimmer and Chappell 1994 and between education and device use Agree 1999; Norburn et al.

1995; Logan and Spitze 1994; Zimmer and Chappell 1994. However, two recent studies of mobility devices suggest e does facilitate the purchase of such equipment Mathieson, Kronenfeld, and Keith 9002 and education facilitates its use alone or bination with formal home care services Agree, Freedman, and Sengupta 2004.

These studies largely ignore, or exclude altogether, the growing Medicare managed care population, now numbering 20 percent of Medicare enrollees Hileman et al. 2002.

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