There’s No Place Like Home: A Qualitative Study of the Working Conditions of Home Health Care Providers

Abstract

Home health care (HHC) is one of the fastest growing US industries. Its working conditions have been challenging to evaluate, because the work environments are highly variable and geographically dispersed. This study aims to characterize qualitatively the work experience and hazards of HHC clinicians, with a focus on risk factors for bloodborne pathogen exposures. The researchers conducted five focus group discussions with HHC clinicians and ten in-depth interviews with HHC agency managers and trade union representatives in Massachusetts. HHC clinicians face serious occupational hazards, including violence in neighborhoods and homes, lack of workstations, heavy patient lifting, improper disposal of dressings or sharp medical devices, and high productivity demands. The social context of the home-work environment challenges the implementation of preventive interventions to reduce occupational hazards in HHC.