Explanatory Variables: Patient, Zip Code, and Hospital Characteristics

We examined differences in the likelihood of receiving home health care across patient, zip code, and hospital characteristics. Patient characteristics included age, sex, race/ethnicity, enrollment in Medicare fee-for-service vs Medicare Advantage, dual enrollment in Medicare and Medicaid, comorbidity burden (using Elixhauser comorbidities), and residence in an urban vs nonurban zip code (measured using Rural-Urban Commuting Area Codes indicating metropolitan area or not).

We also examined 2 socioeconomic characteristics of a patient’s zip code of residence—living in a zip code with a high unemployment rate (the top quartile of unemployment rates by zip code in each state) or not and living in a zip code with a high poverty rate (the top quartile of the percentage living in poverty by zip code in each state) or not. Finally, we examined characteristics of the discharging hospital, including profit status, teaching status, urban vs rural location, large size (≥250 beds), and whether it had a vertically integrated home health agency.