Home Health Care

Report Outline
Upsurge in Elderly Home Care
Quality Control Issues
Long-Term Care Dilemma
Special Focus

Upsurge in Elderly Home Care

America's elderly population is fast-growing, and thus so are the demands on the nation's health care system. Congress and the Reagan administration have begun to examine home health care as part of a solution to the long-term care requirements of the elderly. Their needs, present and future, are being studied by an administration task force whose report is due by Dec. 15. The elderly's present needs, combined with new Medicare limits on hospitalization. have caused a boom in home health care services. The boom is attracting for-profit companies to a field once served almost solely by nonprofit agencies, creating a multibillion-dollar industry.

It is an industry whose expanded range of products and services holds great promise for many of the 27 million Americans who are 65 and older. By some estimates, one-fifth of the people in this age group must receive home care or else be confined to hospitals or nursing homes. A nationwide survey conducted last year indicates that 72 percent of the general population prefers home care over nursing homes, and that home care has a positive image among 85 percent of the people who are aware of it. The reasons for home care's popularity are financial as well as sentimental.

For health planners, government policy makers and health insurance companies, and the patients themselves, there are persuasive reasons for favoring home care over hospital care. In 1985, the average cost of a Medicare-related visit to a home was $53, while per-patient hospital charges averaged $310 a day. The difference would be vastly greater if the patient required use of costly equipment. The American Association of Respiratory Therapy noted in a 1984 report that caring for a ventilator-dependent person at home ran $249,638 less per year than in a hospital.