Doctor of Philosophy (PhD)


Social Work

Document Type



The study was prompted by the need for a social work response to the dramatic changes that have occurred in the home health care arena as a result of managed care policies. Social work has been part of home health care since its inception, but the current cost constrained market threatens the viability of social work in providing servies to elderly, ill, homebound individuals. Medicare home health care benefits have traditionally enabled many elderly individuals to live independently in thier communities. However, passage of the Balanced Budget Act of 1997, which mandated the use of a Prospective Payment System for services reimbursement, has altered the delivery of home health services for many individuals (Liu, Long & Dowling, 2003). As a result, the focus on patient outcomes and the delivery of cost effective quality care has intensified. The study examines the nature of social work services provided in the home health care arena and the relationship between home health care recipient outcomes and a variety of functional and demographic variables as well as social work services. The study utilizes final disposition at discharge from home health care services, and the length of time a recipient is maintained in the community setting through the delivery of home health care services as outcome measures. The key variables of interest are the presence of social work services, the patient's functional status, caregiver status, and the demographic variables age, race and gender. The study is exploratory in nature. It identifies descriptive characteristics of the sample of home health care recipients who received home health care services from one home health care company located in South Central Lousisiana between January 1, 1999 and January 1, 2005. It explores the nature of social work intervention following the passage of the Balanced Budget Act of 1997. Unfortunately, the study results indicated that social work services have become very limited in scope. The major findings indicated that the patient's ability to ambulate independently was a good predictor of his or her ability to remain in the community. They also indicated that the patient's ability to prepare for and plan meals was the only variable to influence the number of days the patient received home care services. Implications for social work are discussed.



Document Availability at the Time of Submission

Release the entire work immediately for access worldwide.

Committee Chair

Timothy F. Page



Included in

Social Work Commons