Home Health Care Services Research Articles

A Multi-Objective Scheduling and Routing Problem for Home Health Care Services via Brain Storm Optimization

At present, home health care (HHC) has been accepted as an effective method for handling the healthcare problems of the elderly. The HHC scheduling and routing problem (HHCSRP) attracts wide concentration from academia and industrial communities. This work proposes an HHCSRP considering several care centers, where a group of customers (i.e., patients and the elderly) require being assigned to care centers. Then, various kinds of services are provided by caregivers for customers in different regions. By considering the skill matching, customers' appointment time, and caregivers' workload balancing, this article formulates an optimization model with multiple objectives to achieve minimal service cost and minimal delay cost. To handle it, we then introduce a brain storm optimization method with particular multi-objective search mechanisms (MOBSO) via combining with the features of the investigated HHCSRP. Moreover, we perform experiments to test the effectiveness of the designed method. Via comparing the MOBSO with two excellent optimizers, the results confirm that the developed method has significant superiority in addressing the considered HHCSRP.

Home Health Care Is Associated With an Increased Risk of Emergency Department Visit, Readmission, and Cost of Care Without Reducing Risk of Complication Following Total Hip Arthroplasty: A Propensity-Score Analysis

BackgroundHome health services have long been implemented for patients to receive additional professional care and supervision following discharge from the hospital to theoretically reduce the risk of complications and health care utilizations. The aim of this investigation was to determine if patients assigned home health services exhibited lower rates of medical and surgical complications, health care utilizations, and costs of care following total hip arthroplasty. MethodsA large national database was retrospectively reviewed to identify all primary total hip arthroplasty patients from 2010 to 2019. Patients who received home health services were matched using a propensity score algorithm to a set of similar patients who were discharged home under self-care. We compared medical and surgical complication rates, emergency room visits, readmissions, and 90-day costs of care between the groups. Multivariate regression analyses were performed to determine the independent effect of home health services on all outcomes. There were 7,243 patients who received home health services and were matched to 72,430 patients who were discharged home under self-care. ResultsPatients who received home health services had higher rates of emergency department visits at 30 days (Odds Ratio [OR] R statistical programming software v 3.6.1 [Lucent Technologies, New Providence, RJ] 1.1544; P = .002) as well as increased readmissions at 30 days (OR 1.137; P = .039); complication rates were similar between groups. Episode-of-care costs for home health patients were higher than those discharged under self-care ($14,236.97 versus $12,817.12; P < .001). ConclusionPatients assigned home health care services exhibited higher costs of care without decreased risk of complications and had increased risk of early returns to the emergency department and readmissions.

Consequences of the Early Phase of the COVID-19 Pandemic for Home-Healthcare Recipients in Norway: A Nursing Perspective.

Municipal home-healthcare services are becoming increasingly important as growing numbers of people are receiving healthcare services in their home. The COVID-19 pandemic represented a challenge for this group, both in terms of care providers being restricted in performing their duties and care receivers declining services for fear of being infected. Furthermore, preparedness plans were not always in place. The purpose of this study is to investigate the consequences for recipients of home healthcare in Norway of the actual level of COVID-19 infection spread in the local population, as observed by licensed nurses working in home-healthcare services. Approximately 2100 nurses answered the survey. The most common adverse consequences for home-healthcare recipients were increased isolation and loneliness, increased health concerns, and the loss of respite care services. An increased burden for relatives/next of kin and fewer physical meetings with service providers were frequently observed and reported as well. This study shows that there were more adverse consequences for service users in municipalities with higher levels of contagion than in those with lower levels of contagion. This indicates that the municipalities adapted measures to the local rate of contagion, in line with local municipal preparedness strategies.

Digital and Home Healthcare Survey among Nigerians: Assessing Awareness, Preferences, and Willingness to Pay for an Integrated Healthcare Ecosystem to achieve Universal Health Coverage

Introduction: The COVID-19 pandemic highlighted the need for evolving an integrated healthcare ecosystem that will connect patients to digital and home healthcare to achieve universal health coverage. The survey aims to assess perceptions and preferences about digital and home healthcare services and develop an integrated healthcare ecosystem. Methods: A survey of 254 Nigerians was conducted to assess their awareness, preferences, and willingness to pay for digital and home healthcare services using electronic questionnaires, and the data were analysed using SPSS 16.0. Results: Males constituted 70.9%, and 61.4% were aged ≤35 years. Two-third were clients, and a third were healthcare providers. Although about 71% patronized public hospitals, there was poor satisfaction (31.7%) than those attending private hospitals that were more satisfied. The male gender, private hospital utilization, and age of ≤35 years were associated with the satisfaction with OR 1.19 (95% CI 0.69-2.05), OR 1.22 (95% CI 0.73-2.04), and OR 2.41 (95% CI 1.38-4.20) respectively. Thirty minutes was the acceptable delay in receiving care by most respondents. Only 39.4% were aware of digital health, and 52.8% were aware of home healthcare. Male gender was associated with DH awareness, while being a healthcare provider was associated with both DH and home healthcare awareness. The respondents' median amount was willing to pay for DH and HH respondents is $1.64 - $6.56 and $3.28 – $6.56, respectively. Conclusion: In response to the survey result, we designed an integrated hospital, digital, and home healthcare project named eDokta, to leapfrog the attainment of universal health coverage in Nigeria.

Digital and Home Healthcare Survey among Nigerians: Assessing Awareness, Preferences, and Willingness to Pay for an Integrated Healthcare Ecosystem to achieve Universal Health Coverage

Introduction: The COVID-19 pandemic highlighted the need for evolving an integrated healthcare ecosystem that will connect patients to digital and home healthcare to achieve universal health coverage. The survey aims to assess perceptions and preferences about digital and home healthcare services and develop an integrated healthcare ecosystem. Methods: A survey of 254 Nigerians was conducted to assess their awareness, preferences, and willingness to pay for digital and home healthcare services using electronic questionnaires, and the data were analysed using SPSS 16.0. Results: Males constituted 70.9%, and 61.4% were aged ≤35 years. Two-third were clients, and a third were healthcare providers. Although about 71% patronized public hospitals, there was poor satisfaction (31.7%) than those attending private hospitals that were more satisfied. The male gender, private hospital utilization, and age of ≤35 years were associated with the satisfaction with OR 1.19 (95% CI 0.69-2.05), OR 1.22 (95% CI 0.73-2.04), and OR 2.41 (95% CI 1.38-4.20) respectively. Thirty minutes was the acceptable delay in receiving care by most respondents. Only 39.4% were aware of digital health, and 52.8% were aware of home healthcare. Male gender was associated with DH awareness, while being a healthcare provider was associated with both DH and home healthcare awareness. The respondents' median amount was willing to pay for DH and HH respondents is $1.64 - $6.56 and $3.28 – $6.56, respectively. Conclusion: In response to the survey result, we designed an integrated hospital, digital, and home healthcare project named eDokta, to leapfrog the attainment of universal health coverage in Nigeria.

Analysis of Home Healthcare Practice to Improve Service Quality: Case Study of Megacity Istanbul.

Home healthcare services are public or private service that aims to provide health services at home to socially disadvantaged, sick, needy, disabled, and elderly individuals. This study aims to increase the quality of home healthcare practice by analyzing the factors affecting it. In Megacity Istanbul, data from 1707 patients were used by considering 14 different input variables affecting home healthcare practice. The demographic, geographic, and living conditions of patients and healthcare professionals who take an active role in home healthcare practice constituted the central theme of the input parameters of this study. The regression method was used to look at the factors that affect the length of time a patient needs home healthcare, which is the study's output variable. This article provides short planning times and flexible solutions for home healthcare practice by showing how to avoid planning patient healthcare applications by hand using methods that were developed for home health services. In addition, in this research, the AB, RF, GB, and NN algorithms, which are among the machine learning algorithms, were developed using patient and personnel data with known input parameters to make home healthcare application planning correct. These algorithms' accuracy and error margins were calculated, and the algorithms' results were compared. For the prediction data, the AB model showed the best performance, and the R2 value of this algorithm was computed as 0.903. The margins of error for this algorithm were found to be 0.136, 0.018, and 0.043 for the RMSE, MSE, and MAE, respectively. This article provides short planning times and flexible solutions in home healthcare practice by avoiding manual patient healthcare application planning with the methods developed in the context of home health services.

Healthcare professionals’ perception of barriers and facilitators for care coordination of older adults with complex care needs being discharged from hospital: A qualitative comparative study of two Nordic capitals

BackgroundThe handover of older adults with complex health and social care from hospital admissions to homebased healthcare requires coordination between multiple care providers. Providing insight to the care coordination from healthcare professionals’ views is crucial to show what efforts are needed to manage patient handovers from hospitals to home care, and to identify strengths and weaknesses of the care systems in which they operate.ObjectiveThis is a comparative study aiming to examine healthcare professionals’ perceptions on barriers and facilitators for care coordination for older patients with complex health and social care needs being discharged from hospital in two capital cities Copenhagen (DK) and Stockholm (SE).MethodSemi-structured interviews were conducted with 25 nurses and 2 assistant nurses involved in the coordination of the discharge process at hospitals or in the home healthcare services (Copenhagen n = 11, Stockholm n = 16). The interview guide included questions on the participants’ contributions, responsibilities, and influence on decisions during the discharge process. They were also asked about collaboration and interaction with other professionals involved in the process. The data was analysed using thematic analysis.ResultsMain themes were communication ways, organisational structures, and supplementary work by staff. We found that there were differences in the organisational structure of the two care systems in relation to integration between different actors and differences in accessibility to patient information, which influenced the coordination. Municipal discharge coordinators visiting patients at the hospital before discharge and the follow-home nurse were seen as facilitators in Copenhagen. In Stockholm the shared information system with access to patient records were lifted as a facilitator for coordination. Difficulties accessing collaborators were experienced in both settings. We also found that participants in both settings to a high degree engage in work tasks outside of their responsibilities to ensure patient safety.ConclusionsThere are lessons to be learned from both care systems. The written e-communication between hospitals and home health care runs more smoothly in Stockholm, whereas it is perceived as a one-way communication in Copenhagen. In Copenhagen there are more sector-overlapping work which might secure a safer transition from hospital to home. Participants in both settings initiated own actions to weigh out imperfections of the system.

Hybrid and herd immunity 6 months after SARS-CoV-2 exposure among individuals from a community treatment program

The death rate from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in 2022 was lower than the death rate in 2021, when the infection rate increased. Hybrid immunity provided by a combination of vaccination and infection, including asymptomatic infection, may confer effective protection against death. We explored the combined effect of asymptomatic infection and hybrid immunity by studying T-cell and antibody responses against SARS-CoV-2 among individuals treated in home health care services 6 months after SARS-CoV-2 exposure. Asymptomatic SARS-CoV-2 infection was demonstrated in 24.4% of close contacts. The levels of immunity were not different between patients and close contacts. Anti-RBD IgG against SARS-CoV-2 increased in a dose-dependent manner with the number of vaccine doses. Interestingly, the T-cell response decreased soon after a booster dose of vaccine. Asymptomatic SARS-CoV-2 infection could not enhance immunity against SARS-CoV-2 among vaccinated close contacts. Full vaccination was crucial to provide hybrid immunity. However, when designing vaccine strategies, T-cell exhaustion after multiple vaccinations should be considered.

“Second set of eyes:” Family caregivers and post-acute home health care during the COVID-19 pandemic

ObjectivesThis study aimed to explore how the COVID-19 pandemic shaped the experiences of family caregivers of older adults who were hospitalized with COVID-19 and discharged to post-acute, skilled home health care (HHC) services. MethodsThirty semi-structured interviews with family caregivers of older adults who received services from a large, not-for-profit HHC agency following hospitalization with COVID-19 infection were conducted between March-July 2021 and analyzed using thematic analysis. ResultsDuring the pandemic, family caregivers encountered societal and institutional barriers to assisting older adults across post-acute care transitions. These barriers included hospital visitation restrictions as well as difficulties accessing community-based resources and medical equipment. Despite limitations and delays in HHC services, many family caregivers identified post-acute HHC, delivered in-person or via telehealth, as important to addressing care gaps for older adults, as well as their own needs for training and support during the pandemic. ConclusionsPolicies intended to reduce the spread of COVID-19 introduced new challenges for caregivers during HHC. However, HHC agencies and their staff adapted within this context to provide a needed bridge of support.

Stress perceptions of nurses serving in home healthcare services during the COVID-19 pandemic: A qualitative research

Objective: To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.Methods: This study was qualitative research with a phenomenological design. Data were collected and recorded through in-depth interviews with 6 nurses working in Muş State Hospital, Home Healthcare Services Unit using a form consisting of 12 questions on an online platform between May 2021 and July 2021. The audio recordings were transcribed by the researcher and content analysis was performed by creating codes, categories, and themes.Results: The interviews yielded 10 categories and 59 sub-codes. These codes were addressed under the theme of "COVID-19 pandemic". Under this main theme, nurses expressed the problems they experienced in issues such as stress, support mechanisms, and family and social problems during COVID-19. They mentioned that they experienced high stress in this process, as well as social isolation and negative thoughts of society about them and that they could not spare time for themselves and their families.Conclusions: Nurses working in home healthcare services frequently express negativities such as high stress, isolation from society, and increased workload. Therefore, actions should be taken to raise awareness of society on these issues, increase the number of personnel, conduct more research, and share the results with the public.

Experiencia de implantación de la Guía de Buenas Prácticas de RNAO «Prevención de caídas y lesiones derivadas de las caídas» en Atención Primaria de Tenerife

Falls are a public health problem with worldwide relevance and are considered the second cause of death due to involuntary trauma. Nurses have a central role in preventing falls by implementing evidence-based recommendations. Good practice guidelines (GBP) allow care to be provided based on the best and most current evidence. The Nurses Association of Ontario (RNAO) develops GBP that it expands worldwide thanks to the Program of Centers Committed to Excellence in Care, BPSO®, in which the Primary Care Management of Tenerife participates, as a candidate center, implementing the Guide «Preventing falls and reducing injury resulting from falls». The objectives of this study were to describe the profile of the patient included in «Home Health Care Service» in the ZBS of the Tenerife Health Area where the GBP is implemented.

Investigation of vitamin D, vitamin B12 and ferritin levels in children receiving Home Health Care Services in Southeastern Turkey

Objective: For proper nutrition of children followed by the Home Health Care (HHC) unit, a close follow-up is extremely important. Vitamin deficiencies are common in children in this group who need parental or caregiver-dependent nutrition. The purpose of this study conducted in Batman Province, was to investigate vitamin D, vitamin B12 and ferritin levels of individuals under 18 years of age who are followed by the HHC unit and continue their lives and treatments at home, except for emergencies. Materials and Methods: This study was derived from the files of 416 pediatric patients who were followed up in Batman Province HHC unit between January 1, 2022, and December 31, 2022. It was designed as a retrospective, single-center study evaluating 25-hydroxyvitamin D (OH) levels, vitamin B12 levels, ferritin levels, and demographic variables from individuals followed by HHC unit. The data were collected from the HHC unit’s files. IBM-SPSS version 24 was used for analysis. Results: The mean age of the 416 children receiving home health care services included in the study was 10.38±4.37 years. 234 (56.2%) of the participants were male and 182 (43.8%) were female. The 25(OH)D level was 18.47±5.41 ng/mL for all ages, and the ferritin level was 34.90 (33.08) ng/mL. The vitamin B12 level was 480.31±190.38 ng/L. The 25-OH-D vitamin levels of the children in the study was significantly low. Conclusion: Patients followed within the scope of home health care services are at risk for malnutrition and vitamin deficiencies, and annual follow-up of the patients in this regard and personalized diet programs should be created. Vitamin D insufficiency and deficiency are common in children in this group, who cannot leave the house except for compulsory situations and cannot benefit from sunlight sufficiently. We think that these children with chronic diseases should take vitamin D prophylaxis.

A New Portable Home Nursing Care Support System with Scheduling and Flexible Real-time Routing Mechanism

&lt;p&gt;With the rapid growth of the elderly population, the need for long-term medical care continues to increase, and reliance on medical and institutional nursing care services is limited. Long-term nursing care at home is a kind of home care service which provides continuous nursing care after discharge from the hospital and is an alternative long term care choice that can relieve the hospital from the pressure of too many long-term care beds. Therefore, how to integrate limited medical resources and create a mobile home care model that attracts more manpower willing to devote themselves to the long-term care service and can upgrade the value of nursing information system has always need a breakthrough in the medical information field. This research is built upon the mobile computing technology to construct a new portable home nursing care support system. The result shows that this mobile home nursing care support mechanism can help patients and their families maintain good quality of life and dignified living. At the same time, caregivers are provided with intelligent guide and medical information support during their implementation of home care medical measures, thereby excluding redundant non-professional medical details and improve the quality of home health care service.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Immediate outcome assessment of the rapid response team of home health care services at King Abdulaziz Medical City in Riyadh.

Paediatrics rapid response team (RRT) is a newly developed service under paediatrics home health care (HHC) programme which is a standby visiting team that responds to non-critical emergency calls. The current study aimed to compare the total emergency visits and hospital admissions before and after implementation of RRT project. A retrospective chart review was conducted from December 2018 to December 2020. Paediatric patients registered under the home health care (HHC) programme were the target population. The admission and hospitalization rates were assessed before and after the implantation of an RRT. The variables related to patient profile were assessed to explore the association between hospitalization and admission. Data for 117 patients and a total of 114 calls attended under HHC covered by RRT were analysed. In the first year after the implementation of RRT, the mean number of ER visits per patient per year was reduced from 4.78 ± 6.10 to 3.93 ± 4.12 with (P value, 0.06). Also, a slight decrease in the mean number of admissions from 3.74 ± 4.43 to a mean of 3.46 ± 4.1 with (P value, 0.29). Follow-up after receiving an RRT call for an initial complaint was statistically significant in reducing both ER visits and hospital admissions within 7 days with a P value of 0.03 and 0.04, respectively. The RRT was effective in decreasing the ER visits and hospital admissions for a very special group of patients. Additionally, the emplacement of proper triaging code at the time of attending to patients helped in reducing unnecessary ER visit and hospital admission.

A new perspective on the role of the occupational therapist in the home rehabilitation of people with physical disabilities

Research shows that housing and health are inextricably linked. People with mobility impairments, whether in wheelchairs or on crutches, face a variety of impediments to urban infrastructure on a daily basis, both within their own home and in their immediate surroundings. The research shows, that disability may be decreased by adapting the environment. The home modifications improve functioning and decrease dependence, impact on general sensation, participation, and higher self-assessment of health. Housing adaptations were identified as one of the ten most promising “preventive interventions” for older people with physical disabilities. Adapting a home to the needs of people with mobility impairments requires an individual approach and comprehensive approach. Interdisciplinary cooperation among specialists from various scientific fields: technical, medical, and social – significantly increases the effectiveness projects. Occupational therapists play a key role in helping patients and their families to plan a safe, functional and comfortable home environment, supporting home healthcare services. Occupational therapists better understand the physical, social, emotional, sensory and cognitive aspects of the person and the relationship between the person, environment and occupation. The aim of the publication was to show the importance of adapting the apartment to the needs of a person with a disability as an important element of supporting the rehabilitation process in the living environment. Particular attention was paid to the role of the occupational therapist as an expert who understands the relationship between the person, the environment and the occupation.

The Practice of home healthcare services by Pharmacists in Saudi Arabia

The Practice of home healthcare services by Pharmacists in Saudi Arabia

Evaluation of malnutrition frequency and related factors of geriatric patients in need of home healthcare

The nutritional status of frail elderly people receiving home health services should be evaluated. This study aimed to determine the nutritional status of patients aged ≥65 years registered in the Home Healthcare Services unit and investigate the factors that may be associated with malnutrition. This cross-sectional descriptive study was conducted during routine visits to patients and their caregivers. A total of 161 patients were asked to fill in surveys asking about sociodemographic characteristics, patient history, and clinical status. Anthropometric measurements were taken from all patients. The Mini Nutritional Assessment Short Form was applied to the patients for screening purposes. Patients who scored ≤11 on the Mini Nutritional Assessment Short Form were then asked to complete the full Mini Nutritional Assessment form. According to the Mini Nutritional Assessment Short Form and Mini Nutritional Assessment tests, almost half of the elderly patients included in the study (49.7%, n=161) were malnourished or at risk of malnutrition. Analyses showed that those who had COVID-19 [odds ratio (OR): 9.423, 95%CI 2.448-36.273) and those diagnosed with dementia/depression (OR: 8.688, 95%CI 3.246-23.255) were more likely to be malnourished, whereas those with diabetes (OR: 0.235, 95%CI 0.084-0.657) were less likely to have malnutrition. Strikingly, those who were fed by caregivers (OR: 15.061, 95%CI 3.617-62.710) were also more likely to be malnourished than those with self-feeding ability. Malnutrition or the risk of malnutrition is common in elderly patients receiving home care services. Many factors can have an impact on malnutrition.

The Sustainable Home Health Care Process Based on Multi-Criteria Decision-Support

The increase in life expectancy has led to a growing demand for Home Health Care (HHC) services. However, some problems can arise in the management of these services, leading to high computational complexity and time-consuming to obtain an exact and/or optimal solution. This study intends to contribute to an automatic multi-criteria decision-support system that allows the optimization of several objective functions simultaneously, which are often conflicting, such as costs related to travel (distance and/or time) and available resources (health professionals and vehicles) to visit the patients. In this work, the HHC scheduling and routing problem is formulated as a multi-objective approach, aiming to minimize the travel distance, the travel time and the number of vehicles, taking into account specific constraints, such as the needs of patients, allocation variables, the health professionals and the transport availability. Thus, the multi-objective genetic algorithm, based on the NSGA-II, is applied to a real-world problem of HHC visits from a Health Unit in Bragança (Portugal), to identify and examine the different compromises between the objectives using a Pareto-based approach to operational planning. Moreover, this work provides several efficient end-user solutions, which were standardized and evaluated in terms of the proposed policy and compared with current practice. The outcomes demonstrate the significance of a multi-criteria approach to HHC services.

HOME HEALTHCARE ACCESS AND UTILIZATION AMONG VULNERABLE POPULATIONS IN THE US AND PUERTO RICO

Abstract Home health (HH) care utilization among Medicare beneficiaries has exploded, serving over 3.3 million users (The Medicare Payment Advisory Commission, 2021). With the aging of the population and the preference for Home- and Community-Based Services and/or person-centered care delivered in the home, HH care use is expected to continue increasing. Prior research has highlighted inequitable access and use of HH rooted in structural and social determinants of health (Fashaw-Walters et al., 2022). However, more research is needed about disparities in timely access to quality of care and outcomes among racial and ethnic and rural populations. Furthermore, the literature regarding post-acute care has often excluded Puerto Rico HH beneficiaries (Rivera-Hernandez et al., 2020). Given the need to ensure equity of care post-pandemic, there is a pressing need to understand disparities in care and outcomes, specifically using representative data. This symposium will feature four presentations that provide novel insight regarding HH care utilization and outcomes among vulnerable populations. Individual presentations will describe 1) Home health care services utilization among Medicare beneficiaries in Puerto Rico; 2) Public reporting role in exacerbating disparities in access; 3) Differences in home healthcare latency following hospitalization for ADRD patients by race/ethnicity and rural and urban locations; 4) Racial disparity in the start of home healthcare in high-risk ADRD patients by the quality of home health and impact on rehospitalization. In addition, studies in this panel will discuss policy and clinical implications, as well as directions for future research regarding equitable access and health outcomes among HH users.

ETHNORACIAL DIFFERENCES IN HOME HEALTHCARE USE: FINDINGS FROM THE NATIONAL HEALTH AND RETIREMENT STUDY

Abstract This study seeks to identify ethnoracial differences in self-reported home health care (HHC) use among older adults. To do so, we examined 8,817 people aged 65 and older from the 2016 wave of the Health and Retirement Study (HRS), a nationally representative survey of older adults in the U.S. The dependent variable was whether HRS participants reported any HHC service use in the past two years. The primary independent variable was ethnoracial grouping, which included non-Hispanic White, non-Hispanic Black, and Hispanic groups. Multivariable logistic regressions stratified by ethnoracial grouping identified correlates of HHC use. We found that HHC use was more prevalent among non-Hispanic Blacks (14.9%) than in non-Hispanic Whites (10.1%) or Hispanics (10.7%). For all ethnoracial groups, increasing age, dementia, activities of daily living impairment, medical comorbidity (except for Hispanics), and hospitalization (in the past two years) were associated with an increased likelihood of HHC use. In addition, we identified ethnoracial differences in the correlates of HHC use. Among non-Hispanic Whites, more formal education and Medicaid insurance were associated with a higher likelihood of using HHC. For non-Hispanic Blacks, residing in rural areas was associated with a decreased likelihood of HHC use, whereas being single and living alone were associated with an increased likelihood of HHC use. This study thereby identified notable ethnoracial differences in the correlates of HHC use among older adults.