Evidence map›Paper›PMID 40058763›Full record

ArticleJournal of the American Medical Directors Association2025

Racial and Ethnic Disparities in Accessing High-Quality Home Health Care among Older Adults with and Without Dementia.

Chenjuan Ma, Bei Wu, Abraham A Brody

Abstract read
In one paragraph

Article in Journal of the American Medical Directors Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Chenjuan MaNew York University Rory Meyers College of Nursing, New York, NY, USA. Electronic address: chenjuan.ma@nyu.edu.
Bei WuNew York University Rory Meyers College of Nursing, New York, NY, USA.
Abraham A BrodyNew York University Rory Meyers College of Nursing, New York, NY, USA; Division of Geriatric Medicine and Palliative Care, New York University Grossman School of Medicine, New York, NY, USA.

Funding

Rutgers-NYU Center for Asian Health Promotion and EquityP50MD017356 · NIMHD · RUTGERS BIOMEDICAL/HEALTH SCIENCES-RBHS · PI WU, BEI · 2021 to 2025
$11.6M
Resource Center for Alzheimer's and Dementia Research in Asian and Pacific AmericansP30AG083257 · NIA · RUTGERS BIOMEDICAL AND HEALTH SCIENCES · PI Cui Yang · 2023 to 2026
$3.5M
Racial/Ethnic Disparities in Home Health Care for Persons with Alzheimer’s Disease and Related DementiasR03AG070581 · NIA · NEW YORK UNIVERSITY · PI MA, CHENJUAN · 2021 to 2022
$291k
NIA NIH HHS P30 AG083257NIA NIH HHS R03 AG070581NIMHD NIH HHS P50 MD017356
6 · The paper itself

Abstract

objectivesHome health care (HHC) plays a pivotal role in serving millions of US adults aging in place. Although the HHC population is growing rapidly in both size and diversity, driven by an aging US population and a changing demographic profile, there are increasing concerns of equity in HHC, particularly regarding how vulnerable populations are affected under current HHC practices. The purpose of this study was to examine the variations in accessing high-quality HHC in racial and ethnic minority groups and persons living with dementia.

designCross-sectional, secondary analysis. SETTING AND

participantsOlder adults who received HHC in 2016 from agencies with a star rating of overall care quality from the Home Health Compare program.

methodsStart of care data from the 2016 HHC Outcome and Assessment Information Set was linked to Master Beneficiary Summary File, Home Health Compare, and Provider of Services file to address the aim. Multinomial regressions were used in analysis when risk-adjusting for individual and agency characteristics.

resultsOur risk-adjusted estimates, based on data from 574,682 older adults aged ≥65 years served by 8634 HHC agencies nationwide (2290 offering high-quality care, 4023 providing moderate-quality care, and 2321 delivering low-quality care), revealed significant disparities. Non-Hispanic Blacks (relative risk ratio, 0.62; 95% CI, 0.61-0.64) and Hispanics (relative risk ratio, 0.72; 95% CI, 0.70-0.74) were significantly less likely to receive care from high-quality agencies. Additionally, having dementia exacerbated disparities in accessing high-quality HHC between racial and ethnic minorities and white Americans. CONCLUSIONS AND IMPLICATIONS: Racial and ethnic minority individuals face significant disadvantages in accessing high-quality HHC, with persons living with dementia from these groups being the most disadvantaged. Further research is warranted to investigate the referral and admission processes for HHC. Our findings highlight the need for actions from clinicians and policymakers to tackle potential biases in the aforementioned care processes.

Indexed as

DementiaEthnicityHealthcare DisparitiesHealth Services AccessibilityHome Care ServicesQuality of Health CareRacial GroupsAgedAged, 80 and overCross-Sectional StudiesFemaleHumansMaleUnited Statescare accesscare qualitydementiadisparitiesHome health care

Identifiers

PMID40058763
PMCPMC12058401

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.