Post-Hospital Home Care of African-American Elderly. Abstract, Executive Summaryand Final Report

摘要

The study tested explanations for established race differences in use of formalservices among elderly discharged home from the hospital. Data sources included medical records, home health agency records, discharge planner records, patient interviews, and nurse-conducted in-home assessments. African American patients and families were more likely to rule out institutional care (intermediate nursing home care) for reasons of preference, engage in less pursuit of nursing home palcements, and more pursuit of formal services in the home. No race differences were found in thoroughness of discharge planning, number of formal home care services arranged by discharge planners, duration of Medicare home health services, or implementation problems. Race was found to indirectly affect level of formal service utilization through functional dependency and living alone. African-American elders were found to enter post-hospital home care with higher levels of physical and cognitive impairment, and to have caregivers with more limitations. Some support was found for race differences in use of religiosity as coping mechanism. Findings clarify the exacerbated risk among African-American elders entering home care, both in terms of greater impairment and in terms of less adequate home care plans.