Intensive Home Health Care in the United States

1987 ◽  
Vol 3 (4) ◽  
pp. 561-573 ◽  
Author(s):  
Daniel M. Fox ◽  
Kathleen S. Andersen ◽  
A. E. Benjamin ◽  
Linda J. Dunatov

AbstractThis paper assesses the impact of mechanisms for financing intensive home health care services in the United States on their utilization. As lengths of stay have decreased in response to prospective payment methods for hospitals, demand has increased for intensive and complex services provided to patients in the home. Third-party payers, however, are willing to satisfy only some of this potential demand that their reimbursement policies have generated. It is the policies of payers rather than the safety and effectiveness of devices and procedures that are the major constraints on the expansion of intensive home health care. We describe the effects of these policies on who receives intensive home health care services, who provides them, what services are provided, how their quality is monitored, and what they cost.

Author(s):  
Jamie M. Smith ◽  
Haiqun Lin ◽  
Charlotte Thomas-Hawkins ◽  
Jennifer Tsui ◽  
Olga F. Jarrín

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. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization admission during 2015. Of these patients, 26.6% were discharged to home health care. To evaluate the association between timing of home health care initiation and 30-day rehospitalizations, multivariate logistic regression models including patient demographics, clinical and geographic variables, and neighborhood socioeconomic variables were used. Inverse probability-weighted propensity scores were incorporated into the analysis to account for potential confounding between the timing of home health care initiation and the outcome in the cohort. Compared to the patients who received home health care within the recommended first two days, the patients who received delayed services (3–7 days after discharge) had higher odds of rehospitalization (OR, 1.28; 95% CI, 1.25–1.32). Among the patients who received late services (8–14 days after discharge), the odds of rehospitalization were four times greater than among the patients receiving services within two days (OR, 4.12; 95% CI, 3.97–4.28). Timely initiation of home health care following diabetes-related hospitalizations is one strategy to improve outcomes.


2016 ◽  
Vol 11 (4) ◽  
pp. 397-414
Author(s):  
Tiffany Henley ◽  
Maureen Boshier

AbstractThe passage of the Affordable Care Act in the United States has opened a policy window for the establishment of an independent Medicaid agency for the Navajo Nation. This article explores several policy options to improve health care services for Native Americans. Although there is a lack of scholarly research on the impact of healthcare reform and the effectiveness of current health care programs for American Indians, policymakers should utilize evidence-based research to inform policy decisions.


2017 ◽  
Vol 29 (3) ◽  
pp. 161-167 ◽  
Author(s):  
Allison Squires ◽  
Timothy R. Peng ◽  
Yolanda Barrón-Vaya ◽  
Penny Feldman

Approximately one in five households in the United States speaks a language other than English at home. This exploratory, descriptive study sought to examine language-concordant visit patterns in an urban home health care agency serving a diverse and multilingual population. Patient care record data combined with administrative data facilitated the exploratory work. In a 2-year period, results showed that among the 238,513 visits with 18,132 limited English proficiency patients, only 20% of visits were language concordant. The study suggests that home health care services may not be meeting the demand for language services, but more research is needed to determine the right “dose” of bilingual home care visits to optimize home care outcomes and establish a standard for care.


1990 ◽  
Vol 3 (1) ◽  
pp. 4-10
Author(s):  
Kate O'Neil ◽  
Leslie LaBelle ◽  
Caryn M. Bing

Home-care services have expanded greatly over the past several decades. Many pharmacy practitioners have little or no exposure to the vast majority of home-care programs. This article provides an overview of home health care services, traces the evolution of these programs and the public policy that has directed that change, and outlines the regulation governing the home-care industry. A synopsis of traditional and nontraditional home-care services precedes a brief review of other specialty services. A summary of the impact of quality management programs and some future trends for home care are presented.


1993 ◽  
Vol 10 (1) ◽  
pp. 39-51 ◽  
Author(s):  
Pamela J. Salsberry ◽  
Jennie T. Nickel ◽  
Muriel O'Connell ◽  
Nancy R. Reynolds ◽  
Diana L. Brady ◽  
...  

2021 ◽  
Vol 46 (8) ◽  
pp. 1-2
Author(s):  
John F. Brehany ◽  

Since their inception in 1948, The Ethical and Religious Directives for Catholic Health Care Services (ERDs) have guided Catholic health care ministries in the United States, aiding in the application of Catholic moral tradition to modern health care delivery. The ERDs have undergone two major revisions in that time, with about twenty years separating each revision. The first came in 1971 and the second came twenty-six years ago, in 1995. As such, a third major revision is due and will likely be undertaken soon.


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