Skilled Nursing Facility Patients Discharged to Home Health Agency Services Spend More Days at Home.
Aged
Female
Home Care Agencies
/ statistics & numerical data
Home Care Services
/ statistics & numerical data
Humans
Inpatients
/ statistics & numerical data
Male
Medicare
New York
Patient Discharge
/ statistics & numerical data
Patient Transfer
Retrospective Studies
Skilled Nursing Facilities
Subacute Care
United States
aging in place
care transitions
health services utilization
post-acute care
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
21
01
2020
revised:
10
03
2020
accepted:
14
03
2020
pubmed:
16
4
2020
medline:
26
2
2021
entrez:
16
4
2020
Statut:
ppublish
Résumé
To investigate the association of the utilization of Medicare-certified home health agency (CHHA) services with post-acute skilled nursing facility (SNF) discharge outcomes that included home time, rehospitalization, SNF readmission, and mortality. Retrospective cohort study. New York State fee-for-service Medicare beneficiaries aged 65 years and older admitted to SNFs for post-acute care and discharged to the community in 2014. A total of 25,357 older adults. The outcomes included days spent alive in the community ("home time"), rehospitalization, SNF readmission, and mortality within 30- and 90-day post-SNF discharge periods. The primary independent variables were SNF five-star overall quality rating and receipt of CHHA services within 7 days of SNF discharge. Zero-inflated negative binomial regression and logistic regression models characterized the association of CHHA linkage with home time and other outcomes, respectively. Following SNF discharge, 17,657 (69.6%) patients received CHHA services. In analyses that adjusted for patient-, market-, and other SNF-level factors, older adults discharged from higher quality SNFs were more likely to receive CHHA services. In analyses that adjusted for patient- and market-level factors, receipt of post-SNF CHHA services was associated with 2.03 and 4.17 (P < .001) more days in the community over 30- and 90-day periods. Receiving CHHA services was also associated with decreased odds for rehospitalization (odds ratio [OR] = .68; P < .001; OR = .91; P = .008), SNF readmission (OR = .36; P < .001; OR = .62; P < .001), and death (OR = .34; P < .001; OR = .63; P < .001) over 30- and 90-day periods, respectively. Among older adults discharged from a post-acute SNF stay, those who received CHHA services had better discharge outcomes. They were less likely to experience admissions to institutional care settings and had a lower mortality risk. Future efforts that examine how the type and intensity of CHHA services affect outcomes would build on this work. J Am Geriatr Soc 68:1573-1578, 2020.
Identifiants
pubmed: 32294239
doi: 10.1111/jgs.16457
pmc: PMC7363542
mid: NIHMS1600007
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1573-1578Subventions
Organisme : NIA NIH HHS
ID : K23 AG058757
Pays : United States
Organisme : NIA NIH HHS
ID : K23AG058757
Pays : United States
Informations de copyright
© 2020 The American Geriatrics Society.
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