Date of Conferral

2023

Degree

Ph.D.

School

Health Services

Advisor

Magdeline Aagard

Abstract

AbstractHome health care services (HHCS) are a cost-effective service option often underutilized by individuals living in low-income communities. For this population, barriers to care may result in higher health care costs and poor health outcomes. Gaps in literature indicated a need to explore experiences of accessing and maintaining home health care among individuals living in low-income communities. The purpose of this qualitative research study was to gain insight into how individuals living in low-income communities perceive their access to HHCS. The conceptual framework used for this phenomenological study was Penchansky and Thomas’s model of access, which addresses access from seven dimensions: (a) affordability, (b) accessibility (c) availability, (d) acceptability (e) adequacy and accommodation; and (f) awareness. Open-ended questions were used in interviews with 14 participants who live in low-income communities and receive HHCS. Themes that arose from the data were: (a) types of HHCS and competent staff, (b) acceptable behaviors and conduct, (c) accommodation and ease of scheduling, (d) availability and access to HHCS, (e) affordable HHCS, and (f) communication. This study identified a need for effective policies to ensure safety for HHC workers, a policy requiring HHC agencies to establish a health equity plan for all patient populations to ensure equitable treatment and access to HHCS, and a policy that requires HHC agencies to provide routine staff training and professional development. Potential implications for positive social change from this study include improved HHCS yielding favorable outcomes and a better patient experience, a highly skilled workforce, and increased safety to ensure equitable treatment and greater access to HHCS.

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