ArticlePloS one2020
Functional outcome in home health: Do racial and ethnic minority patients with dementia fare worse?
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Home Health Care to Asian Americans: a Systematic Review.Journal of racial and ethnic health disparities · 2024Pooled it
- Patient-Driven Grouping Model and Home Health Use Among Traditional Medicare Beneficiaries.Journal of the American Medical Directors Association · 2026Article
- Racial and Sex Differences in Postoperative Mortality Between Patients With Versus Without Dementia.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Utilization of Occupational and Physical Therapy Home Health Visits Among People Living With Dementia With Varying Social Determinants of Health.Journal of the American Medical Directors Association · 2025Article
- Identifying and Reducing Stigmatizing Language in Home Health Care With a Natural Language Processing-Based System (ENGAGE): Protocol for a Mixed Methods Study.JMIR research protocols · 2025Article
- Racial and Ethnic Disparities in Accessing High-Quality Home Health Care among Older Adults with and Without Dementia.Journal of the American Medical Directors Association · 2025Article
- Skilled home healthcare utilization and outcomes for older adults with dementia: A scoping review.Journal of the American Geriatrics Society · 2025Article
- Getting to the root: Examining within and between home health agency inequities in functional improvement.Health services research · 2024Article
- Differences in Home Health Services and Outcomes Between Traditional Medicare and Medicare Advantage.JAMA health forum · 2024Article
- Antipsychotic use among older patients with dementia receiving home health care services: Prevalence, predictors, and outcomes.Journal of the American Geriatrics Society · 2023Article
- Home Health Care Clinicians' Use of Judgment Language for Black and Hispanic Patients: Natural Language Processing Study.JMIR nursing · 2023Article
- Time to dementia diagnosis by race: A retrospective cohort study.Journal of the American Geriatrics Society · 2022Article
- Home Health Agencies With More Socially Vulnerable Patients Have Poorer Experience of Care Ratings.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2022Article
- Evidence for Action: Addressing Systemic Racism Across Long-Term Services and Supports.Journal of the American Medical Directors Association · 2022Article
- Care-Partner Support and Hospitalization in Assisted Living During Transitional Home Health Care.Journal of the American Geriatrics Society · 2021Article
- Utilization and Functional Outcomes Among Medicare Home Health Recipients Varied Across Living Situations.Journal of the American Geriatrics Society · 2021Article
- Factors associated with change in activities of daily living performance in home health care patients with diabetes.Geriatric nursing (New York, N.Y.)Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesEvaluate the independent and interactive effects of dementia and racial/ethnic minority status on functional outcomes during a home health (HH) admission among Medicare beneficiaries.
methodsSecondary analysis of data from the Outcome and Assessment Information Set [OASIS] and billing records in a non-profit HH agency in New York. Participants were adults ≥ 65 years old who received HH in CY 2017 with OASIS records at HH admission and HH discharge. Dementia was identified by diagnosis (ICD-10 codes) and cognitive impairment (OASIS: M1700, M1710, M1740). We used OASIS records to assess race/ethnicity (M0140) and functional status (M1800-M1870 on activities of daily living [ADL]). Functional outcome was measured as change in the composite ADL score from HH admission to HH discharge, where a negative score means improvement and a positive score means decline.
resultsThe sample included 4,783 patients, among whom 93.9% improved in ADLs at HH discharge. In multivariable linear regression that adjusted for HH service use and covariates (R2 = 0.23), being African American (β = 0.21, 95% confidence interval [CI]: 0.06, 0.35, p = 0.005) and having dementia (β = 0.51, 95% CI: 0.41, 0.62, p<0.001) were independently related to less ADL improvement at HH discharge, with significant interaction related to further decrease in ADL improvement. Relative to white patients without dementia, African American patients with dementia (β = 1.08, 95% CI: 0.81, 1.35, p<0.001), Hispanics with dementia (β = 0.92, 95% CI: 0.38, 1.47, p = 0.001) and Asian Americans with dementia (β = 1.47, 95% CI: 0.81, 2.13, p<0.001) showed the least ADL improvement at HH discharge.
conclusionRacial/ethnic minority status and dementia were associated with less ADL improvement in HH with independent and interactive effects. Policies should ensure that these patients have equitable access to appropriate, adequate community-based services to meet their needs in ADLs and disease management for improved outcomes.
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