National Healthcare Disparities Report - LDI Health Economist

Effectiveness of Care
Chapter 2 Functional Status Preservation and Rehabilitation
n From 2002 to 2009, the percentage of home health care patients who got better at walking or moving
around improved for each racial and ethnic group (Figure 2.51).
n The 2008 top 5 State achievable benchmark was 54%. xxx At the current 5% annual rate of increase,
this benchmark could be attained overall in about 4 years.
n Rates of improvement varied across racial and ethnic groups. Whites could attain the achievable
benchmark in about 3 years. Asians and NHOPIs could attain the benchmark sooner than Whites,
while Blacks, AI/ANs, multiple-race individuals, and Hispanics would not attain the benchmark for
between 5 and 11 years.
Also, in the NHQR:
n From 2002 to 2009, the percentage of home health care patients who got better at walking or moving
around improved for the total population.
Outcome: Nursing Home Residents Needing More Help With Daily Activities
Long-stay residents typically enter a nursing facility because they can no longer care for themselves at home.
They tend to remain in the facility for several months or years. While almost all long-stay nursing home
residents have limitations in their ADLs, nursing home staff help residents stay as independent as possible. xxxi
Most residents want to care for themselves, and the ability to perform daily activities is important to their
quality of life. Some functional decline among residents cannot be avoided, but optimal nursing home care
seeks to minimize the rate of decline. This measure uses assessments of need for help with daily activities,
conducted regularly by nursing homes, to identify those residents whose need for help increased from one
assessment to the next.
xxx The top 5 States contributing to the 2008 achievable benchmark are District of Columbia, Hawaii, Kansas, South Carolina, and
Utah.
xxxi In Olmstead v. L.C., 527 U.S. 581 (1999), the U.S. Supreme Court concluded that the unjustified institutionalization of people with
disabilities is a form of unlawful discrimination under the Americans With Disabilities Act of 1990, 42 U.S.C. 12101 et seq. The Court
held that States are required to provide community-based services for people with disabilities who would otherwise be entitled to
institutional services when: (1) such placement is appropriate; (2) the affected person does not oppose such treatment; and (3) the
placement can be reasonably accommodated, taking into account the resources available to the State and the needs of other
individuals with disabilities. More information about the HHS Office for Civil Rights’ Olmstead enforcement efforts is available at
www.hhs.gov/ocr/civilrights/understanding/disability/serviceolmstead/index.html.
122 National Healthcare Disparities Report, 2011