A Cost Benefit Analysis of a Home Care Aide Program Public Deposited

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Last Modified
  • March 21, 2019
  • White, Michelle
    • Affiliation: School of Nursing
  • An exploratory, retrospective study capturing a two year time period was conducted at a licensed home care agency to determine if services provided by Home Care Aides (HCAs) positively impacted patient care outcomes and ultimately provided a cost savings to the health care system. This program evaluation was conducted at a home care agency owned by a large, private, not-for-profit health care system; and explored several interrelated concepts: patient care outcomes, staff training and education, and employee engagement. These concepts ultimately informed a financial evaluation: the Cost Benefit Analysis. Each of these areas shared a common theme, the relationship to quality. Avedis Donabedian’s theory of quality improvement was selected to guide this project. Donabedian’s theory allowed quality metrics to be translated into a meaningful financial comparison outlined by structure, process and outcomes (Donabedian, 1982). For the study period, 2014 to 2015, the agency demonstrated patient satisfaction scores consistently in the 95th percentile and employee engagement scores in the 99th percentile. These scores allowed for consideration that interpersonal relationships contribute to the success of technical skill. Technical skill contributes to decreased acute care utilization and improved patient care outcomes. The results of the evaluation demonstrated that while there is a financial loss to the health care system due to low reimbursement rates and few payor sources for the home care aide services, there was a financial savings in overall health care expense to the federal government and other health insurers. More importantly, the study population receiving HCA services demonstrated fewer hospitalizations and re-hospitalizations as compared to the general Medicare population with similar numbers of chronic health conditions.
Date of publication
Resource type
Rights statement
  • In Copyright
  • Maloney, Nancy
  • Waters, Hugh
  • Foster, Beverly
  • Doctor of Nursing Practice
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2017

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