Healthcare consumers overwhelmingly prefer home-based care. However, difficulties coordinating caregivers or preexisting socioeconomic challenges can lead some patients to favor facility-based alternatives, according to a new study published in JAMA Network Open.
Researchers asked 1,555 adults with an average age of 62.6 years about their willingness to pay for care in various settings. The sample included both patients and caregivers who make care decisions for older family members. The researchers found that both patients and caregivers were more willing to pay for at-home care and overwhelmingly prioritized higher-quality care.
On average, respondents were willing to spend an extra $51.81 for care that takes place in the home, compared to facility-based care such such as that in a skilled nursing facility. They were also more willing to pay more for care that can reduce their recovery time or reduce caregivers’ burden. Caregivers, meanwhile, also prioritized higher-quality care, even if it came with a heftier price tag.
“Our data highlighted a unanimous preference for higher-quality care with a pronounced aversion to below-average care,” the researchers wrote. “Caregivers were more inclined to pay a premium for better care for patients than the patients themselves.”
Respondents who had prior experience with home health agencies were willing to spend the most, on average, for at-home care. These individuals were willing to spend an extra $52.28 per day for care in the home, according to the report.
However, socioeconomically disadvantaged respondents on average had a lower willingness to pay for home-based care. Respondents with job insecurity, or those that were unemployed, were less willing to pay a higher price for home care, according to the study.
Given this, “our financial and social systems must ensure adequate support of home-based care across diverse socioeconomic contexts,” the researchers said.
President Biden recently announced a swath of reforms meant to improve care and better support caregivers, including enhanced access to respite care services, improved funding for services that support caregivers and more.
“Those reforms provide an opportunity to address the underlying complexities identified in our study, ensuring a more equitable distribution of care that reflects patient preferences and caregiver capacities,” the researchers wrote.
And while new payment models seek to shift post-acute care from institutional settings into patients’ homes, stakeholders must ensure these initiatives do not exacerbate care disparities felt among disadvantaged groups, they added.
