Integrating Mental Health Parity for Homebound Older Adults Under the Medicare Home Health Care Benefit

2011 ◽  
Vol 54 (3) ◽  
pp. 309-324 ◽  
Author(s):  
Joan K. Davitt ◽  
Zvi D. Gellis
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rui Zhou ◽  
Joyce Cheng ◽  
Shuangshuang Wang ◽  
Nengliang Yao

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.


2020 ◽  
Author(s):  
Rui Zhou ◽  
Joyce Cheng ◽  
Shuangshuang Wang ◽  
Nengliang (Aaron) Yao

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


2019 ◽  
Vol 7 (4) ◽  
pp. 561-569
Author(s):  
Jo-Ana D Chase ◽  
David Russell ◽  
Meridith Rice ◽  
Carmen Abbott ◽  
Kathryn H Bowles ◽  
...  

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.


2021 ◽  
Vol 111 (12) ◽  
pp. 2239-2250
Author(s):  
Madeline R. Sterling ◽  
Jia Li ◽  
Jacklyn Cho ◽  
Joanna Bryan Ringel ◽  
Sharon R. Silver

Objectives. To determine the prevalence and predictors of US home health care workers’ (HHWs’) self-reported general, physical, and mental health. Methods. Using the 2014–2018 Behavioral Risk Factor Surveillance System, we analyzed the characteristics and health of 2987 HHWs (weighted n = 659 000) compared with 2 similar low-wage worker groups (health care aides and health care support workers, not working in the home). We conducted multivariable logistic regression to determine which characteristics predicted HHWs’ health. Results. Overall, 26.6% of HHWs had fair or poor general health, 14.1% had poor physical health, and 20.9% had poor mental health; the prevalence of each outcome was significantly higher than that of the comparison groups. Among HHWs, certain factors, such as low household income, an inability to see a doctor because of cost, and a history of depression, were associated with all 3 aspects of suboptimal health. Conclusions. HHWs had worse general, physical, and mental health compared with low-wage workers not in home health. Public Health Implications. Increased attention to the health of HHWs by public health experts and policymakers is warranted. In addition, targeted interventions appropriate to their specific health needs may be required. (Am J Public Health. 2021;111(12):2239–2250. https://doi.org/10.2105/AJPH.2021.306512 )


2011 ◽  
Vol 23 (6) ◽  
pp. 435-445 ◽  
Author(s):  
Colleen Delaney ◽  
Richard Fortinsky ◽  
Lorraine Doonan ◽  
Rita L. W. Grimes ◽  
Pearson Terra-Lee ◽  
...  

The increasing prevalence of depression in elderly home health care patients led to a statewide initiative in Connecticut to enhance evidence-based depression treatment for older adults. A training curriculum on depression screening and interventions was developed and disseminated to 25 home care professionals representing 14 agencies in Connecticut using a train-the-trainer model. Home care trainers included nurses and social workers. This article describes Phase I curriculum design and initial evaluation of the impact of the training on the preparation of trainers to provide depression care education at their home care agencies. Several evaluation measures, including an appraisal of the self-reported attitudes and self-efficacy of home care professionals towards depressed older adults, a pre/post-test to assess the trainers’ knowledge, and willingness of trainers to implement the education program at their agencies were used to assess program outcomes. Participants’ self-efficacy levels in screening and caring for depressed older adults was significantly increased following the education program compared to immediately before the education program (t, (24) = -4.204; p < .001).


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