The association among knowledge of and confidence in home health care services, acculturation, and family caregivers' relationships to older adults of Mexican descent

2018 ◽  
Vol 39 (6) ◽  
pp. 689-695
Author(s):  
Janice D. Crist ◽  
Mary Lee Montgomery ◽  
Alice Pasvogel ◽  
Linda R. Phillips ◽  
Evangeline M. Ortiz-Dowling
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Family Caregivers ◽  
Home Health Care ◽  
Health Care Services ◽  
Home Health ◽  
Mexican Descent ◽  
Care Services

scholarly journals Timing of Home Health Care Initiation and 30-Day Rehospitalizations among Medicare Beneficiaries with Diabetes by Race and Ethnicity

2021 ◽  
Author(s):  
Jamie M. Smith ◽  
Olga F. Jarrín ◽  
Haiqun Lin ◽  
Charlotte Thomas-Hawkins ◽  
Jennifer Tsui
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Home Health ◽  
Urban Setting ◽  
Medicare Beneficiaries ◽  
Timely Initiation ◽  
Care Services ◽  
Racial Ethnic

Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. Building on prior findings of racial/ethnic disparities in post-acute referral and utilization of home health, this study examined timing of home health care initiation and 30-day rehospitalization outcomes. Using linked Medicare administrative, assessment, and claims datasets (2014-2016), we identified 209,150 Medicare beneficiaries, age 50 and older, who were referred to post-acute home health following a diabetes-related index hospitalization. Multivariate logistic regression models included patient demographics, neighborhood area deprivation, and rural/urban setting. Home health care initiated within one week was associated with lower risk of 30-day rehospitalization (days 0-2, OR=0.88, 95% CI 0.86-0.91; days 3-7, OR=0.87, CI 0.84-0.90). In contrast, a late start of services (days 8-14) was associated with a higher risk of 30-day rehospitalization (OR=2.2, CI 2.0-2.3). This pattern of results was observed across all racial/ethnic patient groups. However, racial/ethnic minority patients were less likely to receive timely home health care services compared to white patients. Timely initiation and coordination of home health care is one strategy to improve outcomes following diabetes-related hospitalizations that benefits older adults of all racial/ethnic groups.

Differences in Transitional Care Provided to Mexican American and Non-Hispanic White Older Adults

2016 ◽  
Vol 28 (2) ◽  
pp. 159-167 ◽  
Author(s):  
Janice D. Crist ◽  
Kari M. Koerner ◽  
Joseph T. Hepworth ◽  
Alice Pasvogel ◽  
Catherine A. Marshall ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Transitional Care ◽  
Insurance Coverage ◽  
Home Health ◽  
Hospital Length Of Stay ◽  
Care Services ◽  
Hispanic White

Background:Transitional care, assisting patients to move safely through multiple health care settings, may be insufficient for older Hispanic patients. Purpose: Describe home health care services referral rates for Hispanic and non-Hispanic White (NHW) patients and factors that influence case managers’ (CMs’) discharge planning processes. Design: Organized by the Ethno-Cultural Gerontological Nursing Model, health records were reviewed ( n = 33,597 cases) and supplemented with qualitative description ( n = 8 CMs). Findings: Controlling for gender, insurance type, age, and hospital length of stay, NHW older adults received more home health care services referrals (odds ratio = 1.23). Insurance coverage was the most frequent determinant of CMs’ post–hospital care choices, rather than patients’ being Hispanic. NHW older adults were more likely to have insurance than Hispanic older adults. Implications: Insurance coverage being CMs’ primary consideration in determining patients’ dispositions is a form of systems-level discrimination for Hispanic vulnerable groups, which combined with other hospital-level constraints, should be addressed with policy-level interventions.

scholarly journals A qualitative study of home health care experiences among Chinese homebound adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rui Zhou ◽  
Joyce Cheng ◽  
Shuangshuang Wang ◽  
Nengliang Yao
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Qualitative Study ◽  
Home Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Technical Skills ◽  
Home Health ◽  
Care Services ◽  
Homebound Older Adults

Abstract Background Home health care services (HHC) are emerging in China to meet increased healthcare needs among the homebound population, but there is a lack of research examining the efficiency and effectiveness of this new care model. This study aimed to investigate care recipients’ experiences with HHC and areas for improvement in China. Methods This research was a qualitative study based on semi-structured interviews. Qualitative data were collected from homebound adults living in Jinan, Zhangqiu, and Shanghai, China. A sample of 17 homebound participants aged 45 or older (mean age = 76) who have received home-based health care were recruited. Conceptual content analysis and Colaizzi’s method was used to generate qualitative codes and identify themes. Results The evaluations of participants’ experiences with HHC yielded both positive and negative aspects. Positive experiences included: 1) the healthcare delivery method was convenient for homebound older adults; 2) health problems could be detected in a timely manner because clinicians visited regularly; 3) home care providers had better bedside manners and technical skills than did hospital-based providers; 4) medical insurance typically covered the cost of home care services. Areas that could potentially be improved included: 1) the scope of HHC services was too limited to meet all the needs of homebound older adults; 2) the visit time was too short; 3) healthcare providers’ technical skills varied greatly. Conclusions Findings from this study suggested that the HHC model benefited Chinese older adults—primarily homebound adults—in terms of convenience and affordability. There are opportunities to expand the scope of home health care services and improve the quality of care. Policymakers should consider providing more resources and incentives to enhance HHC in China. Educational programs may be created to train more HHC providers and improve their technical skills.

scholarly journals A Qualitative Study of Healthcare Experiences Among Chinese Homebound Adults Receiving Home Health Care Services

2020 ◽  
Author(s):  
Rui Zhou ◽  
Joyce Cheng ◽  
Shuangshuang Wang ◽  
Nengliang (Aaron) Yao
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Qualitative Study ◽  
Home Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Technical Skills ◽  
Home Health ◽  
Care Services ◽  
Homebound Older Adults

Abstract Background: Home health care services (HHC) are emerging in China to meet increased healthcare needs among the homebound population, but research examining the efficiency and effectiveness of this new care model is rare. This study aimed to investigate care recipients’ experiences with HHC and areas for improvement in China.Methods: This research was a qualitative study based on semi-structured interviews. Qualitative data were collected from homebound adults living in Jinan, Zhangqiu, and Shanghai, China. A sample of 17 homebound participants aged 45 or older (mean age = 76) who have received home-based clinical care were recruited. Colaizzi’s descriptive phenomenological method was used to generate qualitative codes and identify themes.Results: The evaluations of participants’ experiences with HHC yielded both positive and negative aspects. Positive experiences included: 1) the healthcare delivery method was convenient for homebound older adults; 2) health problems could be detected in a timely manner because doctors visited regularly; 3) home care providers had better bedside manners and technical skills than did hospital-based providers; 4) medical insurance typically covered the cost of home care services. Areas that could potentially be improved included: 1) the scope of HHC services was too limited to meet all the needs of homebound older adults; 2) the visit time was too short; 3) healthcare providers’ technical skills varied greatly.Conclusions: Findings from this study suggested that the HHC model benefited Chinese older adults, primarily homebound adults, in terms of convenience and affordability. There are opportunities to expand the scope of home health care services and improve the quality of care. Policymakers may consider providing more resources and incentives to enhance HHC in China. Educational programs may be created to train more HHC providers and improve their technical skills.Trial registration: Not applicable

scholarly journals "This Case Is Closed": Family Caregivers and the Termination of Home Health Care Services for Stroke Patients

2006 ◽  
Vol 84 (2) ◽  
pp. 305-331 ◽  
Author(s):  
CAROL LEVINE ◽  
STEVEN M. ALBERT ◽  
ALENE HOKENSTAD ◽  
DEBORAH E. HALPER ◽  
ANDREA Y. HART ◽  
...  
Keyword(s):  
Health Care ◽  
Family Caregivers ◽  
Home Health Care ◽  
Health Care Services ◽  
Home Health ◽  
Stroke Patients ◽  
Care Services

scholarly journals Caregivers’ Experiences Regarding Training and Support in the Post-Acute Home Health-Care Setting

2019 ◽  
Vol 7 (4) ◽  
pp. 561-569
Author(s):  
Jo-Ana D Chase ◽  
David Russell ◽  
Meridith Rice ◽  
Carmen Abbott ◽  
Kathryn H Bowles ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Family Caregivers ◽  
Learning Strategies ◽  
Home Health Care ◽  
Home Health ◽  
Barriers To Learning ◽  
Telephone Interviews ◽  
Qualitative Descriptive ◽  
Training And Support

Background: Post-acute home health-care (HHC) services provide a unique opportunity to train and support family caregivers of older adults returning home after a hospitalization. To enhance family-focused training and support strategies, we must first understand caregivers’ experiences. Objective: To explore caregivers’ experiences regarding training and support for managing older adults’ physical functioning (PF) needs in the post-acute HHC setting. Method: We conducted a qualitative descriptive study using semi-structured telephone interviews of 20 family caregivers. Interviews were recorded, transcribed, and analyzed using conventional content analysis. Results: We identified the following primary categories: facilitators to learning (eg, past experience, learning methods), barriers to learning (eg, learning on their own, communication, timing/logistics, preferred information and timing of information delivery), and interactions with HHC providers (eg, positive/negative interactions, provider training and knowledge). Conclusion: Caregivers were responsive to learning strategies to manage older adults’ PF needs and, importantly, voiced ideas to improve family-focused training and support. HHC providers can use these findings to tailor training and support of family caregivers in the post-acute HHC setting.

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