Identification and referral of hospitalized patients in need of home care

Abstract

Given current concerns about the cost-effectiveness of home health care, better targeting of home health services for high risk groups is viewed as one way to provide controls on both service delivery and costs. The purpose of this exploratory study was to determine the degree to which patients with identifiable levels of need for services were referred for home health care and if selected clinical and functional status measures are useful in distinguishing need for service. Using a convenience sample of 145 patients ready for hospital discharge, data were collected on physical function, dependency at discharge, perceived helpfulness of others, social support, readiness for self-care, and planned adherence to treatment as well as demographic and medical variables. Using a combination of study variables, 93% of patients not in need of services could be correctly classified. In addition, patients in need of service but not referred by their physicians were found to differ significantly from patients not in need of care on all dimensions. Suggestions are offered for further research to determine if and what systematic factors influence referral decisions for home health care and which specific patient characteristics are associated with the most cost-effective long-term outcomes.

Post-Acute Referral Decisions Made by Multidisciplinary Experts Compared to Hospital Clinicians and the Patients’ 12-Week Outcomes

“…In this study, the experts had more time and a less stressful environment in which to make their decisions compared with the time and environment afforded to hospital clinicians. 5,28 Furthermore, the experts in this study were instructed to make their referral decisions based on need without regard for insurance or Medicare eligibility criteria such as being homebound. The analysis did not show that insurance type or homebound status influenced the decisions for either type of decision maker.…”

A Rural Perspective on Home Care Communication about Elderly Patients after Hospital Discharge

“…alternatives (Prescott, Soeken, & Griggs, 1995). The American population is older (Reinhard, 1998), with approximately one third of the American elderly living in rural areas (Moser, 1992).…”

Impact of a telehealth intervention to augment home health care on functional and recovery outcomes of elderly patients undergoing coronary artery bypass grafting

“…After hospital discharge, continued recovery is essential, because patients with unmet follow-up care needs can have difficulty with activities of daily living and declines in self-reported health, frequent emergency department (ED) visits, and costly rehospitalizations. [4][5][6][7][8] Home health care (HHC) is an invaluable component to provide a bridge after hospitalization and provide transitional care in the home, 9 especially for older patients undergoing CABG who often have multiple comorbid conditions and more functional impairments, and may lack needed assistance with home regimens for CABG recovery. For some patients, the functional impairments and decompensation experienced after hospitalization may never be completely reversed.…”