scholarly journals Association of Dementia Severity and Assistances Needs on Missed Home Health Visits

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1034-1034
Author(s):  
Sara Knox ◽  
Brian Downer ◽  
Allen Haas ◽  
Kenneth Ottenbacher
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Psychological Symptoms ◽  
Medication Management ◽  
Early Discharge ◽  
Home Health ◽  
Optimal Care ◽  
Dementia Severity ◽  
Missed Visits

Abstract Individuals with Alzheimer’s Disease and Related Dementias (ADRD) experience barriers to accessing health care services, including services provided during home health care. Additionally, it is not clear if people with ADRD who are admitted to home health care receive all the services needed to maximize their outcomes. Barriers to receiving the optimal care can include the presence or absence of a care giver, behavioral and psychological symptoms of ADRD, or therapists lacking the skills needed to effectively engage patients in therapy sessions. These barriers may vary dependent on the patient’s ADRD severity. The purpose of this study was to examine the relationship between dementia severity and early discharge from home health care. This was a retrospective study of 142,376 Medicare beneficiaries with ADRD who received home health care between October 2016 and September 2017. Early discharge was defined as discharge from home health with more than two missed visits. Early discharge rates were calculated, and multilevel logistic regression was used to estimate the relative risk (RR) of early discharge, by dementia severity level, adjusted for patient and clinical characteristics. 10.4% of beneficiaries had an early discharge. Dementia severity was not associated with risk of early discharge. However, level of medication assistance needed was found to be associated with risk of early discharge (RR=0.849; 95% CI 0.759 - 0.948). Medication management may impact a patient’s ability to adequately attend and engage in home health therapy services. Further studies are needed to better delineate the interaction between medication management and early discharge.

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

2021 ◽  
Vol 18 (11) ◽  
pp. 5623
Author(s):  
Jamie M. Smith ◽  
Haiqun Lin ◽  
Charlotte Thomas-Hawkins ◽  
Jennifer Tsui ◽  
Olga F. Jarrín
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Race And Ethnicity ◽  
Health Care Services ◽  
Propensity Scores ◽  
The United States ◽  
Home Health ◽  
Medicare Beneficiaries ◽  
Timely Initiation ◽  
Care Services

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.

Home Health Care Services for AIDS Patients: One Community's Response

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

scholarly journals Recent planning approaches and mobility concepts for home health care services in Austria – A review

2018 ◽  
Vol 68 (4) ◽  
pp. 205-222
Author(s):  
Patrick Hirsch
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Rural Areas ◽  
Health Care Services ◽  
Home Health ◽  
Future Research ◽  
Comprehensive Overview ◽  
Family Structures ◽  
Routing And Scheduling ◽  
Sustainable Solutions

Summary Home health care (HHC) services are faced with a rising demand in Austria. This is due to an increased life expectancy, changing family structures, and the trend to grow old at home. The percentage of their working time that is spent by the HHC staff for travelling from one client to the next one reaches 30% and even more in some rural areas. Changing the assignment of HHC staff to clients and the sequence of visits can lead to major reductions in the travel distances, and therefore, to more sustainable solutions. The aim of this paper is to provide a comprehensive overview on the logistical planning of HHC services in Austria. In order to meet the future requirements, it is important to analyze different mobility concepts for the HHC staff and to provide tailored solution approaches for routing and scheduling. The reader learns about the current HHC situation in Austria, the logistical requirements for planning these services, possible mobility concepts for the HHC staff, and potential threats for HHC operations. The developed solution methods are presented in brief and the main findings are highlighted and discussed. The paper concludes with an outlook on potential future research paths in HHC routing and scheduling.

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