scholarly journals Drivers of Home Healthcare Industry: Contrasting Views of Users and Providers in a Developing Country

2021 ◽  
pp. 72-80
Author(s):  
Ankit Singh ◽  
Ajeya Jha ◽  
Shankar Purbey
Keyword(s):  
Institutional Care ◽  
Cost Effective ◽  
Home Health ◽  
Home Healthcare ◽  
Health Providers ◽  
Survey Analysis ◽  
Service Usage ◽  
Home Health Agencies ◽  
The Right ◽  
The Cost

Home healthcare fills an important void in a country's healthcare system; factors promoting home healthcare growth vary. In this study, the perceptions of the users and providers are analyzed to identify the important factors. Survey analysis was done for ten identified factors on 378 nurses and 394 patients. Responses were analyzed with Garret Ranking Method. The systematic random sampling method was used after acquiring the list of nurses working in home health organizations. The preference should be given to the user's perception as the customer is the king; it is encouraging for Indian home health providers that users are feeling they are deriving benefits from home health service usage; however, this feeling can be further enhanced by focusing on the right factors such as doctors recommendation, the rise of chronic diseases and the cost advantage associated with home health over Institutional care. Results revealed a disparity between the perceptions of the providers and users. This study suggests that home health agencies highlight features, such as cost-effective care, medical professionals' recommendation, and utility in providing relief to chronic disease patients.

scholarly journals The Policy Implications of the Cost Structure of Home Health Agencies

2014 ◽  
Vol 4 (1) ◽  
pp. E1-E24 ◽  
Author(s):  
Dana Mukamel ◽  
Richard Fortinsky ◽  
Alan White ◽  
Charlene Harrington ◽  
Laura White ◽  
...  
Keyword(s):  
Home Health ◽  
Cost Structure ◽  
Policy Implications ◽  
Health Agencies ◽  
Home Health Agencies ◽  
The Cost

Cost Comparison of Fan-out Wafer Level Packaging and Flip Chip Packaging

2017 ◽  
Vol 2017 (DPC) ◽  
pp. 1-37 ◽  
Author(s):  
Amy Lujan
Keyword(s):  
Flip Chip ◽  
Cost Effective ◽  
Cost Comparison ◽  
Cost Modeling ◽  
Wafer Level ◽  
Design Features ◽  
Wafer Level Packaging ◽  
Flip Chip Packaging ◽  
The Right ◽  
The Cost

In recent years, there has been increased focus on fan-out wafer level packaging with the growing inclusion of a variety of fan-out wafer level packages in mobile products. While fan-out wafer level packaging may be the right solution for many designs, it is not always the lowest cost solution. The right packaging choice is the packaging technology that meets design requirements at the lowest cost. Flip chip packaging, a more mature technology, continues to be an alternative to fan-out wafer level packaging. It is important for many in the electronic packaging industry to be able to determine whether flip chip or fan-out wafer level packaging is the most cost-effective option. This paper will compare the cost of flip chip and fan-out wafer level packaging across a variety of designs. Additionally, the process flows for each technology will be introduced and the cost drivers highlighted. A variety of package sizes, die sizes, and design features will be covered by the cost comparison. Yield is a key component of cost and will also be considered in the analysis. Activity based cost modeling will be used for this analysis. With this type of cost modeling, a process flow is divided into a series of activities, and the total cost of each activity is accumulated. The cost of each activity is determined by analyzing the following attributes: time required, labor required, material required (consumable and permanent), capital required, and yield loss. The goal of this cost comparison is to determine which design features drive a design to be packaged more cost-effectively as a flip chip package, and which design features result in a lower cost fan-out wafer level package.

scholarly journals PATTERNS OF PERFORMANCE ON QUALITY OF CARE AMONG U.S. HOME HEALTH AGENCIES, 2015-2017

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S494-S494
Author(s):  
Chenjuan Ma
Keyword(s):  
Quality Of Care ◽  
Home Health ◽  
Community Dwelling ◽  
Home Healthcare ◽  
Healthcare Sector ◽  
Star Rating ◽  
Health Agencies ◽  
The Us ◽  
Home Health Agencies

Abstract Home healthcare is a critical care source for community-dwelling older adults. As the fastest growing healthcare sector in the US, quality of home healthcare is under increasing scrutiny. The purpose of this study is to examine patterns of performance on quality of care among US home health agencies. This is a 3-year cohort study using 2015-2017 Home Health Compare data and Provider of Services (POS) Files. In the dataset, each HHA was assigned a star rating (1-5) to reflect the overall quality of care. This indicator was calculated based on two process measures (timely initiation of care and drug education) and six outcome measures (e.g., hospitalization). We examined 8,020 HHAs in the US. Over the 3-year period, the number of HHAs receiving a star rating of 4 or 5 increased from 27% in 2015, 31% in 2016, to 32% in 2017. Roughly, 32% of the HHAs received a lower star rating and another 32% received a higher star rating from 2015 to 2016. Similarly, 30% of the HHAs received a lower star rating and 29% of the HHAs received a higher star rating from 2016 to 2017. Hospital-based HHAs were less likely to receive a star rating of 4 or 5. Larger HHAs (OR 1.34; 95% CI, 1.13-1.59) and HHAs with ownership changes (OR, 1.38; 95% CI 1.20-1.59) were more likely to improve their star ratings overtime. Our finding indicates dynamic changes in the quality of care within the US home healthcare sector.

scholarly journals 2444. Infection Prevention in Home Healthcare: Results from a National Study of Home Health Agencies

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S845-S845
Author(s):  
Monika Pogorzelska-Maziarz ◽  
Jingjing Shang ◽  
Ashley Chastain ◽  
Patricia Stone
Keyword(s):  
Infection Prevention ◽  
Qualitative Interviews ◽  
Nationwide Survey ◽  
The United States ◽  
Home Health ◽  
Home Healthcare ◽  
Infection Prevention And Control ◽  
National Study ◽  
Health Agencies ◽  
Home Health Agencies

Abstract Background As the population of older Americans with chronic conditions continues to grow, the role of home healthcare (HHC) services in improving care transitions between acute care and independent living has become a national priority. This has led to the development of value-based purchasing (VBP) initiatives, changes in the Centers for Medicare and Medicaid Services’ Home Health Conditions of Participation, and the Joint Commission’s national patient safety goals for HHC. We aimed to describe the infection prevention and control (IPC) infrastructure in US home health agencies (HHA). Methods From March to November 2018, we conducted in-depth, phone interviews with 41 staff from 13 HHAs across the United States, including administrators, IPC and quality improvement (QI) personnel, registered nurses and home health aides. In October 2018, we launched a nationwide survey to a random sample of 1,500 HHAs stratified by census region, ownership status and urban/rural location, and achieved a 40% response rate. Transcripts of the qualitative interviews were coded and themes were identified using content analysis. Survey data were analyzed using descriptive statistics. Results Themes from the interviews included: 1) Uniqueness of HHC setting, 2) Importance of staff and patient/caregiver education, (3) Care coordination challenges, and, (4) Keys to success and innovation. From the surveys, we found that, at the majority of HHAs, the staff member in charge of IPC had other responsibilities including QI (57%), clinical/administrative/managerial (49%), supervision of clinical services/patient coordination (48%), and education/training (45%). For those staff members in charge of IPC, over a third had received no specific IPC training, and only 5% were certified in IPC. For those staff who received training, the training was provided by external consultants (26%) or a professional society/health department (28%). Respondents cited the most challenging aspect of IPC as collecting/reporting infection data (24%), adherence to/monitoring bag technique (15%) and adequate staff coverage (13%). Conclusion This work represents a current snapshot of IPC infrastructure and challenges in US HHC agencies and identifies important barriers to IPC in these settings. Disclosures All authors: No reported disclosures.

Cultural Competence in Home Healthcare Nursing: Disparity, Cost, Regulatory, Accreditation, Ethical, and Practice Issues

2019 ◽  
Vol 32 (2) ◽  
pp. 76-80
Author(s):  
Mary Curry Narayan
Keyword(s):  
Cultural Competence ◽  
Home Health Care ◽  
Ethical Issues ◽  
Quality Care ◽  
Home Health ◽  
Home Healthcare ◽  
Culturally Competent ◽  
Vulnerable Patient ◽  
Home Health Agencies ◽  
The Many

Home healthcare patients, who are members of minority, marginalized, or vulnerable patient populations, are at risk for healthcare disparities. Inadequate attention to the needs of the many different types of diverse patient populations seen by home health agencies could compromise an agency’s outcome indicators, reimbursement in value-based payment programs and responsibility to deliver equitable quality care. Culturally competent home health nurses may have a role in decreasing disparities and improving patient outcomes. This article discusses the incidence of disparities in home health care and highlights literature about the economic, regulatory, accrediting, policy, social justice, and ethical issues surrounding disparate and inequitable care for home healthcare patients. Patients in need of culturally competent care include those characterized by diversity related to race, ethnicity, language, religion, socioeconomic status, sexual orientation, gender identification, mental and physical disabilities, and stigmatized diagnoses (e.g., obesity and substance abuse). Home healthcare nurses who strengthen the cultural competence of their care may be able to decrease the incidence of disparate outcomes. By investing in the cultural competence of their home healthcare nurses, agencies may strengthen their commitment to their missions and the financial health of their agencies.

Preventive Antibiotics in Stroke Study (PASS)

Neurology ◽  
2018 ◽  
Vol 90 (18) ◽  
pp. e1553-e1560 ◽  
Author(s):  
Willeke F. Westendorp ◽  
Elles Zock ◽  
Jan-Dirk Vermeij ◽  
Henk Kerkhoff ◽  
Paul J. Nederkoorn ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Acute Stroke ◽  
Resource Use ◽  
Institutional Care ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Control Group ◽  
Open Label ◽  
The Cost

ObjectiveTo evaluate the cost-effectiveness of preventive ceftriaxone vs standard stroke unit care without preventive antimicrobial therapy in acute stroke patients.MethodsIn this multicenter, randomized, open-label trial with masked endpoint assessment, 2,550 patients with acute stroke were included between 2010 and 2014. Economic evaluation was performed from a societal perspective with a time horizon of 3 months. Volumes and costs of direct, indirect, medical, and nonmedical care were assessed. Primary outcome was cost per unit of the modified Rankin Scale (mRS) and per quality-adjusted life year (QALY) for cost-effectiveness and cost-utility analysis. Incremental cost-effectiveness analyses were performed.ResultsA total of 2,538 patients were available for the intention-to-treat analysis. For the cost-effectiveness analysis, 2,538 patients were available for in-hospital resource use and 1,453 for other resource use. Use of institutional care resources, out-of-pocket expenses, and productivity losses was comparable between treatment groups. The mean score on mRS was 2.38 (95% confidence interval [CI] 2.31–2.44) vs 2.44 (95% CI 2.37–2.51) in the ceftriaxone vs control group, the decrease by 0.06 (95% CI −0.04 to 0.16) in favor of ceftriaxone treatment being nonsignificant. However, the number of QALYs was 0.163 (95% CI 0.159–0.166) vs 0.155 (95% CI 0.152–0.158) in the ceftriaxone vs control group, with the difference of 0.008 (95% CI 0.003–0.012) in favor of ceftriaxone (p = 0.006) at 3 months. The probability of ceftriaxone being cost-effective ranged between 0.67 and 0.89. Probability of 0.75 was attained at a willing-to-pay level of €2,290 per unit decrease in the mRS score and of €12,200 per QALY.ConclusionsPreventive ceftriaxone has a probability of 0.7 of being less costly than standard treatment per unit decrease in mRS and per QALY gained.

Determining the cost optimum among a discrete set of building technologies to satisfy stringent energy targets

2015 ◽  
Vol 29 (4) ◽  
pp. 417-427
Author(s):  
Brian Simmons ◽  
Matthias H.Y. Tan ◽  
C.F. Jeff Wu ◽  
Godfried Augenbroe
Keyword(s):  
Optimization Algorithm ◽  
Energy Savings ◽  
Combinatorial Problem ◽  
Cost Effective ◽  
Design Parameters ◽  
Large Set ◽  
Operational Energy ◽  
Optimization Methodology ◽  
The Right ◽  
The Cost

AbstractThis paper presents the development of an optimization methodology for selecting the lowest monetary cost combinations of building technologies to meet set operational energy reduction targets. The new optimization algorithm introduced in this paper departs from the notion that optimal design choices over a large set of design parameters and properties can be driven by energy targets. We assume that design parameters are determined by many concurrent considerations fighting over the attention span of the design team. Our approach starts from a design outcome and asks the question, which set of discrete technologies are the right mix to reach an energy target in the cost optimal way? Such an approach has to face the challenge that the properties of market-available building technologies have a discrete nature that makes their optimal selection a combinatorial problem. The optimization algorithm searches the discrete combinatoric space by maximizing the following objective function: calculated energy savings divided by premium cost, where cost is defined as the additional cost over a baseline solution. The algorithm is codified into a custom MATLAB script and when compared to prescriptive methodologies is shown to be more cost effective and generically applicable given a palette of building technology alternatives and their corresponding cost data.

scholarly journals Information management goals and process failures during home visits for middle-aged and older adults receiving skilled home healthcare services after hospital discharge: a multisite, qualitative study

2018 ◽  
Vol 28 (2) ◽  
pp. 111-120 ◽  
Author(s):  
Alicia I Arbaje ◽  
Ashley Hughes ◽  
Nicole Werner ◽  
Kimberly Carl ◽  
Dawn Hohl ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Health ◽  
Home Healthcare ◽  
Health Providers ◽  
Middle Aged ◽  
Home Health Services ◽  
Hospital To Home ◽  
Health Transitions ◽  
Process Failures ◽  
Related Process

BackgroundMiddle-aged and older adults requiring skilled home healthcare (‘home health’) services following hospital discharge are at high risk of experiencing suboptimal outcomes. Information management (IM) needed to organise and communicate care plans is critical to ensure safety. Little is known about IM during this transition.Objectives(1) Describe the current IM process (activity goals, subactivities, information required, information sources/targets and modes of communication) from home health providers’ perspectives and (2) Identify IM-related process failures.MethodsMultisite qualitative study. We performed semistructured interviews and direct observations with 33 home health administrative staff, 46 home health providers, 60 middle-aged and older adults, and 40 informal caregivers during the preadmission process and initial home visit. Data were analysed to generate themes and information flow diagrams.ResultsWe identified four IM goals during the preadmission process: prepare referral document and inform agency; verify insurance; contact adult and review case to schedule visit. We identified four IM goals during the initial home visit: assess appropriateness and obtain consent; manage expectations; ensure safety and develop contingency plans. We identified IM-related process failures associated with each goal: home health providers and adults with too much information (information overload); home health providers without complete information (information underload); home health coordinators needing information from many places (information scatter); adults’ and informal caregivers’ mismatched expectations regarding home health services (information conflict) and home health providers encountering inaccurate information (erroneous information).ConclusionsIM for hospital-to-home health transitions is complex, yet key for patient safety. Organisational infrastructure is needed to support IM. Future clinical workflows and health information technology should be designed to mitigate IM-related process failures to facilitate safer hospital-to-home health transitions.

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