Survey highlights need for public education
Public needs to learn more about home care
A new study suggests that the home care industry needs to do a better job of educating the public about what home care can provide and how it is reimbursed.
"We definitely need to direct educational efforts toward having everybody know about home care and what the eligibility criteria are about," says Leslie Jean Neal, PhD, RNC, CRRN, assistant professor at Marymount University in Arlington, VA. Neal recently spoke about her survey results at the National Association for Home Care’s 19th Annual Meeting & HOMECARExpo, held Sept. 23-27 in New Orleans.
"I’ve been in home health for more than 10 years and have encountered people who are not familiar with home health services," Neal says. "Patients I had taken care of would say they wished they had known about home health earlier for their mother or family member, and so it seemed clear to me that there wasn’t a high level of awareness about home care."
What does the public know?
Neal conducted the survey to find out exactly what the public understands about home health services. The study found that while most people say they are familiar with the terms "home care" and "home health," they do not have a clear picture of what kinds of services home care agencies provide, and they do not know whether they are personally eligible for those services.
With grant funding from the Virginia Foundation of Independent Colleges and the National Association for Home Care (NAHC) in Washington, DC, Neal sent 4,125 surveys last summer to home care agencies across the United States. The agencies distributed the surveys in public places where people had time to read while they waited, including libraries, doctors’ offices, community centers, and supermarkets. The only criterion was that responses from people working in a health care profession were excluded. The survey had an 8% response rate, with 320 surveys returned from 27 states.
The survey asked people to provide demographic information and posed questions about skilled services, support services, and home health equipment.
Neal says the survey should be seen as a pilot study, and it needs to be repeated on a larger scale. With enough funding, the survey could be conducted by telephone and elicit thousands of responses. Meanwhile, Neal expects the results of the pilot study to be published sometime within the next year.
Here are a few of the survey’s findings:
• When asked whether they were familiar with the term "home health or home care," 89% of respondents said yes. Neal says she was a little surprised that statistic was so high. "But you can’t look at that statistic by itself because while they may have heard those terms, they know very little beyond having heard those terms."
• When asked if they were eligible to receive services in the home, 43% said yes, and 56% said no. That response was not significantly different by gender or age. There was a difference by ethnicity, but because the sample size was so small, Neal advises caution in drawing conclusions until a larger study is conducted.
There were 277 Caucasian respondents, 11 African-American, three Hispanic, 22 Native American, and seven who responded "other" or did not answer. All three Hispanic respondents said they didn’t know whether they were eligible to receive home care services; 73% of African-Americans answered no, and 64% of Native Americans didn’t know. By comparison, 54% of Caucasian respondents answered no. There were no Asian respondents.
• Respondents were asked if their insurance, whether Medicare, Medicaid, or private, paid for skilled services such as nursing, therapy, nutritionist, and social work. Half of the white respondents said they didn’t know, while two of the three Hispanic respondents said they didn’t know. Also, 27% of the Native American respondents and 36% of the African-American respondents said they didn’t know.
• Respondents also were asked if their insurance would cover home health support services, defined as a companion aide, homemaking services, and Meals on Wheels, and 65% of all respondents said they didn’t know.
• When asked whether they knew how to obtain skilled services, "no" answers were given by two of the three Hispanics, 64% of African-Americans, 45% of Caucasians, and 27% of Native Americans.
Home care agencies could help improve public education about their services by targeting educational campaigns to physicians’ offices, hospital physicians, local media, discharge planners, institutional staff, nursing homes, hospitals, and skilled nursing facilities, Neal says.
Agencies also might offer educational material in Spanish to reach Hispanic consumers, and it may be a good idea to hold open houses in ethnic neighborhoods, community centers, and community health clinics. Neal says there has been previous unpublished research that suggests home care agencies particularly need to focus on educating minorities.
Agencies could hand out home health brochures to people waiting to receive flu shots at a mobile van site or blood bank, Neal suggests.
"There are any number of ways that home care agencies can reach people in their own language and try to help people understand what’s available," she says.
Source
• Leslie Jean Neal, PhD, RNC, CRRN, Assistant Professor, Marymount University, 2807 North Glebe Road, Arlington, VA 22207. Telephone: (703) 284-1589. Fax: (703) 284-3819. E-mail: [email protected].
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