scholarly journals Development and validation of a predictive model for identification of probable dementia in home health care patient population using routinely collected assessment data

2019 ◽  
Author(s):  
Olga F. Jarrín
Keyword(s):  
Health Care ◽  
Predictive Model ◽  
Home Health Care ◽  
Patient Population ◽  
Care Patient ◽  
Home Health ◽  
Assessment Data ◽  
Dementia Diagnosis ◽  
Technical Paper ◽  
Development And Validation

Placeholder for technical paper with details of development and validation of a predictive model for dementia diagnosis.

A Checklist To Assess the Need for Home Health Care: Instrument Development and Validation

1987 ◽  
Vol 4 (4) ◽  
pp. 212-218 ◽  
Author(s):  
Judith Garrard ◽  
Bryan E. Dowd ◽  
Beverly Dorsey ◽  
Janet Shapiro
Keyword(s):  
Health Care ◽  
Instrument Development ◽  
Home Health Care ◽  
Home Health ◽  
Development And Validation

Problem with nebulized medications in a home health care patient

2002 ◽  
Vol 59 (15) ◽  
pp. 1462-1463 ◽  
Author(s):  
Steven L. Clause ◽  
Darren M. Triller
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Care Patient ◽  
Home Health

The Home Health Groupings Model: Should Historical Practice Shape Future Payment?

2017 ◽  
Vol 29 (2) ◽  
pp. 126-129 ◽  
Author(s):  
Teresa Lee ◽  
Melissa O’Connor
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Practice Patterns ◽  
Prospective Payment System ◽  
Home Health ◽  
Payment System ◽  
Patient Assessment ◽  
Assessment Data ◽  
Health Payment ◽  
Historical Practice

In November 2016, the Centers for Medicare and Medicaid Services published a report commissioned from Abt Associates titled “Medicare Home Health Prospective Payment System: Case-Mix Methodology Refinements, Overview of the Home Health Groupings Model.” The report presents a proposal to dramatically change Medicare payment for home health care. Based on Medicare claims and home health patient assessment data from 2013, the proposal and its approach raise issues and questions about whether historical practice patterns in home health care provide optimal grounding for a redesign of the home health payment system of the future.

The Hospice Decision: Psychosocial Facilitators and Barriers

1997 ◽  
Vol 35 (2) ◽  
pp. 193-217 ◽  
Author(s):  
Dennis P. McNeilly ◽  
Kristine Hillary
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Home Health Care ◽  
Hospice Care ◽  
Care Patient ◽  
Home Health ◽  
Care Staff ◽  
Future Research ◽  
Health Care Staff ◽  
Hospice Patient

This study examined the social and contextual process of discussion and decision making around the use of the hospice in order to clarify the facilitative and obstructive aspects to hospice patient entry. Four participants groups of physicians, hospice and home health care patient family survivors, and hospice and home health care staff, completed four complementary mail surveys of their discussions and decision process for hospice care. Non-parametric analysis of the data reaffirmed the central and key role of the physician as the expected initiator and gatekeeper of the hospice discussion and decision-making process. Physicians were found generally aware of hospice and to have discussed hospice with their patients, though that awareness and the frequency of hospice patient discussions varied by the type of medical practice. Patient family survivors were unaware of hospice prior to the terminal illness, with a majority of hospice patient family survivors receiving their initial hospice information from relatives. Implications of these results and issues for future research are identified.

scholarly journals Patient Cognitive Impairment Associated With Greater Care Intensity During Medicare Home Health Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 188-188
Author(s):  
Julia Burgdorf ◽  
Kathy Bowles
Keyword(s):  
Health Care ◽  
Cognitive Impairment ◽  
Home Health Care ◽  
Home Health ◽  
Cognitively Impaired ◽  
Medicare Beneficiaries ◽  
Assessment Data ◽  
Care Needs ◽  
Nationally Representative ◽  
Health Payment

Abstract Medicare beneficiaries with cognitive impairment are more likely to access home health care than those without such impairment, and an estimated 1 in 3 Medicare home health patients has diagnosed dementia. However, recent changes to the Medicare home health payment system do not adjust for patients’ cognitive impairment. To the extent that cognitive impairment prompts higher intensity care, this could create a financial disincentive for providers serving this patient population. We draw on a nationally representative sample of 1,214 (weighted n=5,856,333) community-living Medicare beneficiaries who received home health care between 2011-2016. We measure care intensity by the number and type of visits received during an index home health care episode. We model care intensity as a function of patient cognitive impairment during the episode, measured via clinician reports in standardized patient assessment data. In propensity score adjusted, multivariable models holding all covariates at their means, home health patients with identified cognitive impairment received a significantly greater number of visits. During the index home health episode, cognitively impaired patients received an additional 2.82 total visits (95% CI: 1.32-4.31; p<0.001), 1.39 nursing visits (95% CI: 0.49-2.29; p=0.003), 0.72 physical therapy visits (95% CI: 0.06-1.39; p=0.03), and 0.60 occupational therapy visits (95% CI: 0.15-1.05; p=0.01). Findings suggest that recent changes to Medicare home health care reimbursement do not reflect the more intensive care needs of patients with cognitive impairment, and may threaten access to care for these individuals.

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