The world is aging. This paper focuses on the home health care sector. The authors have examined the patient experience aspects of the elderly population. The Agency for Healthcare Research and Quality (AHRQ) designed a Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey specifically for the home healthcare population (HHCAHPS). This paper has identified super-performers within the U.S. home healthcare agencies. By super-performers, this research implies agencies that received superior consumer experience ratings among the U.S. home healthcare segment. The authors applied machine learning techniques to compose a predictive model and identify the predictors of super-performer agencies. The study signals the need for clinically oriented variables for a better model. This paper intends to continue this research with the additional clinically-driven care measures for the patients at home.
TopGrowth In The Aging Population
The global population aged 60 and up is projected to reach some 2 billion by 2050 (United Nations, 2017). That accounts for an estimated 28% of the present global population. The largest growth is expected in Asia. “By 2030, 71 million Americans (about 20% of the U.S. population) will be 65 and older” (Health & Aging, 2021). One of the major challenges for the aging sector is healthcare (National Research Council (US), 2001).
While at a macro level, healthcare policymakers adjust policies and healthcare capacity based on overall census and other socio-economic factors, there are no healthcare-specific initiatives for the aging sector. The United States Health and Human Services made several changes to prepare the providers for seniors in recent years. Typically, the U.S. elderly are served by providers in the post-acute arena such as the home health care agencies, long-term care, long-term-acute-care hospitals, skilled nursing facilities, rehab centers, adult day care, palliative care, and hospices, etc. Despite several changes initiated by the US Health and Human Services agency to prepare the providers for seniors, there is insufficient research on how effective these policies have performed in improving the healthcare outcomes for the aging population.
For example, the all-cause 30-day-readmission (30DRA) shows some improvement for the general population although lacks specific data concerning the elderly (Nastars, Rojas, Ottenbacher, & Graham, 2019; Schneider, O'Donnell, & Dean, 2009). These studies were conducted primarily on hospitalized patients, the effect of chronic obstructive pulmonary disease (COPD) and multiple chronic conditions on the Medicare population on the all-cause 30-day-readmission rates. Most of the recent studies, cited above, do not include the post-acute sector, quality of services, and predictors for superior performers. Thus, despite several changes initiated by the U.S. Health and Human Services agency to prepare the providers for seniors in recent years, there is insufficient research on how effective these policies have performed in improving the healthcare outcomes for the elderly population.
For the growing aging population, 28% are living alone (Guia, 2018). One out of every two seniors living alone feels lonely and sad (Marak, 2018). Additional research is needed to identify predictors of healthcare providers who tend to serve the elderly with superior quality of care. This objective serves as the major motivator for the current and subsequent studies.
Sudden Changes in Health
Nazario (2020) points out examples of sudden risk symptoms of health conditions that become visible, beyond 50 (Nazario, 2020):
- •
Nine out of ten seniors have one or multiple chronic diseases. These include diabetes, chronic obstructive pulmonary disease (COPD), hypertension, hearing and vision issues, organ issues, etc.
- •
Proportionately more seniors suffer from mental issues as we age (CMSS, 2015).
- •
Seniors are more susceptible to infectious diseases and recently, the COVID-19 pandemic (Kaye, 2011).
- •
The risk of a fall is significantly higher after age 70 (Yoshida, n.d.).
- •
The likelihood of debilitating mental health problems is more prevalent in elderly people who are not only physically but also feel they are socially isolated.
- •
This makes a public policy focus on the mental state of elderly people as one of the fastest-growing public health issues in America that needs immediate attention (CDC, n.d.).
- •
During the pandemic, the elderly faced a higher rate of mortality. 8 out of 10 deaths from COVID-19 are among people 65 years and older (CDC, 2020).
In sum, quality of care, patient safety, and superior services are critical requirements for the elderly.