Date of Conferral

10-17-2025

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Miriam Ross

Abstract

The health outcome of reducing 30-day Medicare readmissions continues to be a constant measurement of quality patient care. Post-acute services, like home health care, play a vital role in national efforts to improve patient care, contributing to cost reductions. This quantitative study explored the relationship between home health agency (HHA) ownership (for-profit vs. nonprofit) and Medicare 30-day readmissions by race, age, and gender. The three research questions addressed the independent variable, type of HHA ownership (for-profit vs. nonprofit), and the impact on the dependent variables, 30-day Medicare readmissions by race, age, and gender in Illinois. Binomial logistic regression was used to analyze the data using the Statistical Package for the Social Sciences (SPSS, Version 28). Secondary data obtained from the Centers for Medicare and Medicaid Services (CMS) data sets were used in the analysis to determine hospital-wide-all-cause readmissions. The Donabedian model on structure, process, and outcomes categories applied to preventable readmissions and provided the theoretical framework for this study. For all three research questions, the null hypothesis was rejected in favor of the alternative, indicating statistically significant associations between nonprofit home health agency (HHA) ownership and Medicare 30-day readmission rates for (a) Black patients (OR = 1.346, 95% CI: 1.054-1.720, p =.017, (b) patients aged 80 – 84 (OR = 1.379, 95% CI: 1.100-1.729, p =.005) and over 84 (OR = 1.256, 95% CI: 1.143-1.380, p <.001), and (c) female patients (OR = 1.180, 95% CI: 1.107-1.257, p <.001). The results of this study contributed to positive social change by allowing home health administrators to develop and implement best practices to reduce preventable readmissions, drive quality, and enhance patient outcomes.

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