Abstract The purpose of this study was to identify, from routinely collected health care record data, patient characteristics that describe home care clients' health care needs and explain variation in home health care utilization. Retrospective data were obtained from a total of 317 home health care patient records from one home health care agency. Outcome variables of care included number of visits and hours of care. Predictor variables included nursing diagnoses, medical diagnoses, and patient demographic variables. Nursing diagnoses were classified by the Omaha System. Nursing diagnoses explained a significant amount of variance over and above the demographic and medical diagnosis variables in both the number of nursing visits and hours of nursing care. The results of this study suggest that data related to nursing diagnoses are a valuable source of information when examining home health care nursing resource use.