Exploring beyond adherence to clinical processes: Determinants of desirable discharge to community rates in US home healthcare agencies

This research explores the factors influencing observed Discharge to the Community (DTC) rates in Home Healthcare Agencies (HHAs) beyond adherence to clinical measures. This study aimed to identify key factors influencing DTC rates by analyzing data from the CAHPS Home Health Care Survey and demographic information from the service areas of HHAs. The study utilized multiple classification methods, and the outcomes from the Random Forest model are presented, given its superior performance. The number of Home Healthcare episodes in an agency is linked to better DTC rates than the national average. Medicare spending per episode compared to the national average was also crucial. Socioeconomic factors of the population served such as median income and the percentage of insured individuals also significantly affect DTC rates, stressing the connection between demographic determinants and healthcare outcomes. While following clinical measures is important, findings highlight the critical role of agency characteristics, socioeconomic factors, and tailored care. Policymakers and home healthcare providers should consider these influences when designing interventions for improving patient discharge outcomes in home healthcare.