Home health care use has grown rapidly in response to government incentives and the aging of the population. To better understand home health care use, the proposed study will compare two methods of subject selection to assess the correlates of elderly home health care recipients, using data from the 1984 National Health Interview Survey Supplement on Aging (SOA). Most studies of home health care have focused on functionally- impaired persons, or on service users; few compared elderly home health care users to similar elderly community residents who used other, or no community services. This study consists of two parts: 1) cross-sectional analyses will describe correlates and patterns of care among respondents who report functional limitations in Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). These analyses will replicate previous studies on correlates of home health care that were drawn from functionally-dependent samples. 2) Case-control analyses will evaluate the association of ADL and IADL limitations and other sociodemographic factors among home health care users (e.g., respondents who report current home health aide or visiting nurse use in the community services section of the SOA), matched to other community service users and to non-service users. The case-control analyses will provide an alternative, statistically- powerful comparison of users and non-users, within the preview of community-based services available to the elderly. Comparison of the conclusions drawn from these two methods will indicate the effects of selection criteria on these associations. These analyses will lay the basis for subsequent studies to compare the outcomes of home health care versus other patterns of care for the elderly. Hypotheses generated from this study about the predictors, continuity, and effects of home health care use will be tested prospectively in the Longitudinal Study of Aging (LSOA) dataset and in smaller studies to be initiated among elderly home health care recipients in the Washington, D.C. area.
