Publication Date


Advisor(s) - Committee Chair

David Dunn, Robert Baum, Patricia Minors

Degree Program

Department of Public Health

Degree Type

Master of Science


In today's competitive home health industry, productivity has become a major concern, and establishing productivity expectations is necessary for survival. Productivity can be described as a relationship between the outputs produced by an organization and the inputs provided to create the outputs. This means that the outputs consist of the number of home visits performed and the inputs consist of the time, supplies, mileage, and administrative support necessary for producing home visits. In order to have a complete understanding of productivity, one must understand the importance of examining significant service delivery factors that are unique to the home health industry. This study focuses on two such factors: nursing employment and patient care and service. The nursing employment quality indicators include the nursing personnel functions such as orientation programs. home health nursing experience, educational preparation, and staff development. The patient care and service quality indicators include activities that are related to direct and indirect patient care such as the actual home visit; geographic area, travel time; amount of time required to admit a patient. caseload expectations. time it takes to complete paperwork requirements; staffing; and follow-up with doctors, other home health team members, and other service providers.

This observational cross-sectional study was conducted among Kentucky Medicare and Medicaid certified home health agencies belonging to the Kentucky Home health Association. The necessary data to determine average daily registered nursing patient visits productivity for home health agencies by organizational type was obtained from information in the Kentucky Semi-Annual Home Health Services Report 1991-2. The statistical technique, one-way analysis of variance, was used to analyze whether there were differences in the patient visit productivity outcomes for the home health registered nurses. No significant differences were found.

The second part of this study involved surveying the study population to determine the effect that overall average daily registered nursing patient visits productivity had on nursing employment and patient care and service quality indicators. The survey instrument was subjected to a peer review evaluation team process to improve its validity before administration. The questionnaires were mailed to the study population during March 1993. The questionnaire return rate was 63.86%. Results of the survey were demonstrated in regular frequency distribution tables. The questionnaire results demonstrated that in some of the nursing employment and patient care and service areas for quality indicators, differences may exist. Some of the home health organizational types place more emphasis in some quality areas than in others. For example, hospital-based home health agencies allow more time for orientation and in-service training, have more home health experienced registered nurses, provide more time for paperwork completion, and allow more time for follow-up activities.


Medicine and Health Sciences | Nursing | Public Health | Public Health and Community Nursing