ASPE Contract: Understanding the Home and Hospice Care Workforce

by Published On: Aug 27, 2012

Two prominent research organizations are joining forces to analyze the frontline workforce in home and hospice care.

Social and Scientific Systems Inc., and the LeadingAge Center for Applied Research, its subcontractor, will conduct the analysis using a contract from the U.S. Department of Health and Human Services, Office of the Assistant Secretary forPlanning and Evaluation (ASPE). 

The project is expected to help researchers better understand the ability of the home and hospice care workforce to meet the growing demand for high-quality care for elderly and younger individuals who live at home or in community-based settings.  

Building on Ongoing Work 

The ASPE contract will help Social and Scientific Systems, Inc. and the Center for Applied Research continue their ongoing ASPE-supported work to analyze the 2007 National Home Health Aide Survey (NHHAS) and the 2007 National Home and Hospice Care Survey (NHHCS) datasets.  

Using a 2011 ASPE contract, the two research partners are developing a state policy database featuring information about health care, long-term care, and labor policies. The database also includes information about key state characteristics, including socio-demographic characteristics, public program expenditures, and size of the health care labor force.  

The project team is currently linking its state database to the NHHAS and NHHCS and conducting a series of inter-related analyses intended to further its understanding of the home health care industry. 

Linking Databases for Increased Understanding 

The research partners will use the newest ASPE contract to continue their analysis of the NHHAS and NHHCS. Specifically, the team will link those databases with national, state, and county-level data to examine the association between state polices and:

  • Outcomes associated with frontline home care workforce, such as supply, recruitment and retention. 
  • Organizational characteristics like training and culture. 
  • Because study data is limited to agency-employed workers, the research team will not be exploring the consumer-directed workforce.  

Broad Interest in Developing a Quality Workforce 

A number of policies are driving much of the broad-based interest in the development and sustainability of a quality frontline home care workforce. These policies include: 

  • Expansion of home and community-based service programs in response to consumer preferences and legal mandates.
  • Growth of home-based post-acute and palliative care. This growth has encouraged substantial use of home health and hospice care.  
  • An increased focus on care coordination and integration. The success of this coordination depends on the participation of home health and home and community-based providers, and a trained, competent home care workforce. 
  • Laws that allow nurses to delegate certain tasks to direct care workers under their supervision. Such delegation requires a knowledgeable, skilled and stable home care workforce and nurse supervisors who can facilitate the safe empowerment of these workers. 

Implications for Policy Makers and Providers 

The ASPE project offers a unique opportunity to explore, and provide evidence-based solutions to address, the myriad care-related issues facing policy makers, providers, and consumers. This multi-level study will provide a better understanding of: 

  • The size and major characteristics of the frontline home care workforce.
  • How policy, agency-level and other environmental characteristics influence the availability of the workforce.
  • The impact that these caregivers have on successful policy implementation, provider practice and quality outcomes.   

About The Office of the Assistant Secretary for Planning and Evaluation 

ASPE is the principal advisor to the secretary of the U.S. Department of Health and Human Services (HHS) on policy development, and is responsible for major activities in policy coordination, legislation development, strategic planning, policy research, evaluation, and economic analysis. More information is available at ASPE.  


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