HealthDay News — According to a report from the United Hospital Fund and the Alliance for Home Health Quality and Innovation, about 6 to 28% of seniors refuse home health care offered when they are discharged from the hospital.

Carol Levine, from the United Hospital Fund, and Teresa Lee, JD, MPH, from the Alliance for Home Health Quality and Innovation, explored the issues related to home care refusals and crafted policies to ensure appropriate post-hospital care.

According to the report, the importance of home health care services, including skilled care and personal care, is increasing in discharge planning and transitional care, partly as a result of shorter hospital stays and more complex post-discharge needs. Some studies show that patients receiving post-discharge home health care are less likely to be readmitted, while other studies show improved quality of life. About 6 to 28% of those eligible for home health care refuse these services for various reasons.

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Inflexible criteria for eligibility, inadequate payment for home health care agencies’ services for patients, and shortages of trained workforce are policy and system barriers to accessing services. 

Recommendations include improving communication about care challenges and home health care services, research on aspects of home health refusals, policy changes to increase access and coordination, and continuity across providers and care settings.

“As the trend toward moving care from hospital to community escalates, it will become even more important to develop programs and practices, supported by policy and financial incentives, to give patients the best care possible in their own homes and to support the family caregivers who are essential partners in home health care,” the authors write.


Levine C and Lee T. ““I Can Take Care of Myself!” Patients’ Refusals of Home Health Care Services.” United Hospital Fund. 2017;1-19.

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