The demand for home health care has skyrocketed in recent years. The aging population and the push for more efficient delivery of hospital services have fueled this growing demand. However, health care financing reforms have constrained the industry's growth. Home health agencies struggle to deliver high-quality services while staying within the financial limitations imposed by reimbursement changes. Telehomecare is one way to provide cost-effective care in the current environment. Personal computers and video equipment can transmit data over ordinary telephone lines and allow home health providers to monitor patients and provide care at a much lower cost than earlier technologies that required wider bandwidth telephone lines and more complex equipment. But can telehomecare yield cost-savings for home health agencies? This article addresses the costs associated with a telehomecare intervention in a large, urban, home health agency. The purpose of the study was two-fold: (1) to test the effects of telehomecare on clinical outcomes, and (2) to estimate the financial costs associated with providing telehomecare services. Our results show that, while telehomecare imposes additional expenses for care delivery, it contributes substantial savings without compromising quality. Additionally, we found that the financial benefit increases exponentially as the duration of the patient care episode increases.

BackgroundHerpes zoster (HZ), also known as shingles, is a painful and commonly occurring condition in the United States. In spite of a universally recommended vaccine for use in immunocompetent adults aged 60 years and older, HZ continues to impact the American public, and a better understanding of its current incidence is needed. The objective of the current study is to estimate the overall and age- and gender-specific incidence rates (IRs) of HZ among an immunocompetent US population in 2011 following availability of a vaccine.MethodsClaims data from the Truven Health MarketScan® Research databases between 01/01/2011 and 12/31/2011 were extracted. Immunocompetent adult patients, enrolled as of January 1, 2011 were analyzed. The denominator was defined as eligible subjects who were immunocompetent, had no evidence of zoster vaccination, and no diagnosis of HZ (International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code 053.xx) in the 90 days prior to January 1, 2011. Subjects contributed person-days to the denominator until the occurrence of one of the following events: end of continuous enrollment in the database, a claim for zoster vaccination, diagnosis of HZ or end of the observation period (December 31, 2011). The numerator was defined as enrollees within the denominator file exhibiting evidence of HZ. Annual IRs were calculated for the entire population in the database as well as by gender and age group; standardized IRs were also produced using the 2010 US Census data.ResultsThe overall annual IR of HZ across all ages was 4.47 per 1000 person-years (95 % confidence interval [CI]: 4.44–4.50) which monotonically increased with age from 0.86 (95 % CI: 0.84–0.88) for those aged ≤19 to 12.78 (95 % CI: 12.49–13.07) for patients ≥80 years. The IR was 8.46 (95 % CI: 8.39–8.52) among adults ≥50 years and 10.46 (95 % CI: 10.35–10.56) among those aged ≥60 years. Women compared to men had higher HZ incidence (5.25, 95 % CI: 5.21–5.29 vs. 3.66, 95 % CI: 3.62–3.69) and this was seen across all age groups. When adjusted for age and gender using 2010 US Census data, the annual IR was 4.63 per 1000 person-years (95 % CI: 4.61–4.66).ConclusionsDespite the availability of a vaccine, HZ remains common among immunocompetent adults in the US with incidence rates of HZ observed to increase with age and be higher in women than men.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1262-8) contains supplementary material, which is available to authorized users.

No abstract

Employers that implement teleworking policies may be able to reduce employee-to-employee transmission of respiratory illness, including seasonal and pandemic influenza.

The burden of RSV-LRI was substantial among early-preterm Medicaid infants. Costs were also higher among late-preterm relative to full-term infants.