Caregiving in a patients place of residence: Turnover of direct care workers in home care and hospice agencies

Janette S. Dill, John Cagle

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Objectives: High turnover and staff shortages among home care and hospice workers may compromise the quality and availability of in-home care. This study explores turnover rates of direct care workers for home care and hospice agencies. Methods: OLS (ordinary least square) regression models are run using organizational data from 93 home care agencies and 29 hospice agencies in North Carolina. Results: Home care agencies have higher total turnover rates than hospice agencies, but profit status may be an important covariate. Higher unemployment rates are associated with lower voluntary turnover. Agencies that do not offer health benefits experience higher involuntary turnover. Conclusion: Differences in turnover between hospice and home health agencies suggest that organizational characteristics of hospice care contribute to lower turnover rates. However, the variation in turnover rates is not fully explained by the proposed multivariate models. Future research should explore individual and structural-level variables that affect voluntary and involuntary turnover in these settings.

Original languageEnglish (US)
Pages (from-to)713-733
Number of pages21
JournalJournal of aging and health
Issue number6
StatePublished - Sep 2010
Externally publishedYes

Bibliographical note

Funding Information:
The authors would like to express their appreciation to Drs. Jen Craft-Morgan, Thomas R. Konrad, and Victor Marshall for their help to develop this manuscript. This project was originally funded by Robert Wood Johnson Foundation and Atlantic Philanthropies. Dr. Cagle’s efforts were supported, in part, by a T-32 training grant from the National Institute on Aging (NIA), 2T32AG000272-06A2.


  • end of life
  • labor force
  • nursing assistants
  • residential health care
  • retention


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