Agency Ownership, Patient Payment Source, and Length of Service in Home Care, 1992-2000

Abstract

Purpose: The purpose of this article is to estimate the effect of obesity on both the length of life and length of nondisabled life for older Americans. Design and Methods: Using data from the first 3 waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey, this article develops estimates of total, active, and disabled life expectancy for obese and nonobese older men and women. We used the Interpolation of Markov Chains (IMaCh) method to estimate the average number of years obese and nonobese older persons can expect to live with and without activity of daily living (ADL) disability. Results: Our findings indicate that obesity has little effect on life expectancy in adults aged 70 years and older. However, the obese are more likely to become disabled. This means that obese older adults live both more years and a higher proportion of their remaining lives disabled. Implications: The lack of significant differences in life expectancy by obesity status among the old suggests that obesity-related death is less of a concern than disability in this age range. Given steady increases in obesity among Americans at all ages, future disability rates may be higher than anticipated among older U.S. adults. In order to reduce disability among future cohorts of older adults, more research is needed on the causes and treatment of obesity and evaluations done on interventions to accomplish and maintain weight loss.

Preference of place for end-of-life cancer care and death among bereaved Japanese families who experienced home hospice care and death of a loved one

“…While past research has documented the dichotomous negative [5] and positive effects of caregiving [21,[31][32][33], there has been little research into the details of caregiving consequences and the influence on preference for place of care and death. Concerns about being a burden to others is reported as the major consideration in decisionmaking regarding the place of death [34], but, in our study, preference for home is likely to be associated with the there are reports about the differences of length of service among care settings [35][36][37], the preference of place and the relationship to length of service has not been considered. However, short enrollment periods could impede the full benefit of hospice care [37]; therefore, we recommend that short-term enrollment in home hospice is inappropriate because early entry would benefit the patient and family who desire home death.…”

Agency Characteristics and Changes in Home Health Quality After Home Health Compare

“…Thus, the agency characteristics assessed in the literature are likely to be relevant for our study that examines agencies' responses to HHC. These agency attributes include (a) agency ownership (Brega, Jordan, & Schlenker, 2003;FitzGerald et al, 2006;Han, Remsburg, Lubitz, & Goulding, 2004;Jette, Smith, & McDermontt, 1996;McCall, Petersons, Moore, & Korb, 2003;Murkosky, Phillips, McCarthy, Davis, & Hamel, 2003), (b) whether an agency is hospital-based (Brega et al, 2003;Han, McAuley, & Remsburg, 2007;Jette et al, 1996;Porell, Liu, & Brungo, 2006;Williams, 1994), and (c) Medicare tenure-the number of years an agency has been Medicare-certified (Brega et al, 2003;Porell et al, 2006).…”

Competition and Quality in Home Health Care Markets

“…Addressing the issue of home health quality is important as demand for home health care is expected to continue to grow given technology advancement expanding the type of home health services (Levine et al ., 2003; Han et al ., 2007) and given that home health care is viewed as a cost-effective alternative to facility-based care (Chen et al ., 2000; Konetzka et al ., 2008). Recent quality initiatives by the Center for Medicare and Medicare Services in home health care include market-based approaches, such as public reporting and P4P programs.…”