Home Health Care

Home health care has become the fastest growing segment of the health services industry. Expansion of medicare benefits, lower costs for care at home relative to hospital care, and modern technology have contributed to this growth. Although home health care is not a replacement for all hospital services, it has become an important setting for delivering preventive, diagnostic, therapeutic, rehabilitative, and long-term maintenance services.

According to employment data from the Current Employment Statistics survey, one in five jobs created in the nonfarm economy since January 1988 has been in the health services industry. Within health services, employment in home health care has risen by 168 percent (or 345,000 additional jobs). In contrast, employment in hospitals has increased by 18 percent--580,000 additional jobs (see table). Since health services are always in demand, the health care industry is recognized for its strength in bad times as well as good. For example, during the most recent employment recession, June 1990 through February 1992, employment in the health services industry grew 7.5 percent while employment in the total nonfarm economy fell 1.7 percent. During the first 3 years of the recovery period following this recession, home health care had the third largest increase of all industries, following mortgage bankers and brokers and title insurance.

Home Health Care Profile

Home health care services, as defined in the Standard Industrial Classification Manual 1987, are "establishments primarily engaged in providing skilled nursing or medical care in the home, under the supervision of a physician." Services range from helping with basic activities of daily living to caring for patients needing specialized care for AIDS or cancer chemotherapy. Time with the patient can range from 1 hour a week to around-the-clock care.

According to the Occupational Employment Statistics survey, home health aides(1) are the most common providers of care to individuals at home, accounting for 31 percent of the industry. Various professional health providers make up 32 percent, of which 20 percent are registered nurses, and 7 percent are licensed practical nurses. Personal and home care aides(2) account for 13 percent, and the remainder is comprised of other specialized personnel such as physical therapists, social workers, and speech pathologists.

(1) Home health aides have been defined by the Occupational Employment Statistics survey as those who care for elderly, convalescent, or handicapped persons in the home of the patient. They perform duties for patients such as changing bed linens, preparing meals, assisting in and out of bed, bathing, dressing, and grooming, and administering oral medications under a doctor's orders or at the direction of a nurse.

(2) Personal and home care aides have been defined by the Occupational Employment Statistics survey as those who perform a variety of tasks at places of residence. Their duties include keeping a house and advising families with problems such as nutrition, cleanliness, and household utilities.

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