Most of the results published in National Health Statistics Report No. 52 (dated 18 April 2012) will not surprise any of us caring for elderly parents or other loved ones. The report, entitled Characteristics and Use of Home Health Care by Men and Women Aged 65 and Over, will not make any lists of bestsellers, is neither shocking nor groundbreaking, and is likely to be read mostly by health care and government professionals.
Nevertheless, it does have something to tell us all. Expanding access to home health care is widely seen as a cost-saving strategy as the nation comes to grips with a rapidly aging population and the ever-soaring costs of health care, nursing home care included. The theory is that if the elderly and chronically ill can stay at home and receive their care there, everyone benefits.
The main objective of the present study was to look at the differences in the use of home health care between men and women over the age of 65. What do you think they found, right off the bat? That old men use home health care at a considerably lower rate than women. Why is this? Because they are so much healthier? No. Because their wives are their primary caregivers most of the time. Should they outlive their wives or be on their own because of divorce or other reasons, they will need more help from either their grown children or from public sources. This means the home health care sector will have to greatly expand or more and more adults will have to leave the workforce to care for aging family members and loved ones. We can’t put everyone in nursing homes anymore — way too expensive.
The data are from the 2007 National Home and Hospice Care Survey (NHHCS). The 2007 NHHCS is part of a series of nationally representative, cross-sectional sample surveys designed to provide information on home health care and hospice agencies, their staffs, the services they provide, and the people they serve. In 2oo7, more than one million men and women 65 and older received home health care each day.
The Services Received
- The services usually received by home health care patients aged 65 and older included:
- Gender differences were found for three of these commonly used services. Men were more likely to receive skilled care, including wound care and physical therapy, while women were nearly twice as likely to receive homemaker services.
The prevalence of eight common chronic conditions were studied:
- About half of home health care patients over 65 had essential hypertension (48%)
- 39% had heart disease
- 32% had diabetes mellitus
- 15% had chronic obstructive pulmonary disease and allied conditions
- 13% had osteoarthritis and allied disorders, except spine
- 10% had dementia
- 9% had malignant neoplasma
- 8% cerebrovascular disease
- Gender differences were found for three of these eight chronic conditions:
- Among home health care patients, women were more likely than men to have hypertension.
- Among home health care patients, women were almost twice as likely as men to have osteoarthritis.
- Among home health care patients, men were nearly twice as likely to have malignant neoplasms.
Definitions of terms relating to home health care patients
- Age: the patient’s age at the time of the interview.
- Chronic conditions: Up to 16 diagnoses were included in the analysis. The diagnoses were coded according to the International Classification of Diseases, Ninth Revision, Clinical Modification. The following conditions were the focus:
- essential hypertension (401)
- heart disease (391-392.0, 393-398, 402, 404, 410-416, 420-429)
- diabetes mellitus (250)
- chronic obstructive pulmonary disease and allied conditions (490-496)
- osteoarthritis and allied conditions, except spine (715)
- malignant neoplasms (140-208, 230-234)
- dementia (290, 294, 331.0)
- cerebrovascular disease (430-435, 437, 438)
- Home health care: refers to a range of medical and therapeutic services as well as other services delivered at a patient’s home or in a residential setting in order to promote, maintain or restore health or maximize the level of independence while minimizing the effects of disability and illness, including terminal illness.
- Homemaker services: includes assistance in personal care, maintenance of a healthy and safe environment and services to enable a patient to carry out a plan of care.
- Post-acute care: refers to a patient who was an inpatient in a hospital, nursing home or other health facility before receiving home health care.
- Primary caregiver: a person who helps the majority of the time in caring for someone who is disabled, ill or aged. Caregivers can be relatives or friends who volunteer their time and help; or some people who provide caregiving services for a cost.
Next, we will review more results and summarize the findings.