Racial and Ethnic Differences in Post-acute Home Health Services Among Older Adults With Alzheimer's Disease and Related Dementias.

Abstract

Home health is critical for older adults with Alzheimer's Disease and Related Dementias (ADRD), and more therapy and/or nursing visits are linked to better home health outcomes. Yet, whether visit frequency varies by race and ethnicity remains unclear. Using Medicare claims data in 2019 and 2021, we analyzed a cohort of 301,916 fee-for-service hospitalized Medicare beneficiaries with ADRD, investigating differences in nursing and therapy visits within 30-day post-discharge across racial and ethnic groups, and changes during the COVID-19 pandemic. On average, patients received 5.1 nursing and 6.2 therapy visits pre-pandemic, declining to 4.6 and 5.2, respectively, in 2021. Black individuals experienced the most notable drop in nursing visits, while racially and ethnically minoritized groups consistently received fewer therapy visits compared to White counterparts, both before and during the pandemic. These results highlight persistent differences in home health utilization, with implications for policy promoting equitable access for minoritized populations.