2.50
Hdl Handle:
http://hdl.handle.net/10755/159392
Type:
Presentation
Title:
Resource Use and Patient Outcomes in Home Health Agencies
Abstract:
Resource Use and Patient Outcomes in Home Health Agencies
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2003
Author:Pace, Karen
Contact Address:5104 Foxridge Dr., Apt. 2B, Mission, KS, 66202, USA
Home health care is the provision of skilled and/or personal care services in the home, which are provided directly, delegated, or coordinated primarily by nurses. The purpose of this study was to describe and analyze how average resource use relates to patient outcomes after controlling for case mix (patient characteristics). The study was framed using Donbedian's Structure-Process-Outcome Model for Quality Assessment. Resource use, a process indicator, was measured as the average number of visits and cost per patient. The outcomes included agency rates for hospitalization, discharged and remaining in the community, emergent care, and improvement in bathing, ambulation, and medication management. The study design was retrospective observational with secondary analysis of case mix and outcomes data from the Outcome and Assessment Information Set and resource use from FY99 Medicare cost reports. A diverse, nonrandom sample of 277 home health agencies met the inclusion criteria. Multiple regression analysis and risk adjustment procedures were used with the agency as the unit of analysis. Agency case mix (patient characteristics) explained large amounts of the variation in the outcomes across agencies (20% for improved ambulation to 61% for discharged in the community). Resource use and outcomes were correlated, indicating higher resource use was associated with poorer outcomes. However, after controlling for case mix, resource use did not contribute to explained variance of the functional outcomes and only marginally contributed to explained variance in agency rates for hospitalization and discharged in the community. It is important not to conclude there is no relationship between resource use and outcomes. One implication is that average resource use may not be as important as the mix of services and the appropriateness of the care processes in determining outcomes. Therefore, for the range of resource use and outcomes examined, agencies possibly could improve outcomes without necessarily increasing cost. AN: MN030311
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleResource Use and Patient Outcomes in Home Health Agenciesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/159392-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Resource Use and Patient Outcomes in Home Health Agencies </td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Pace, Karen</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">5104 Foxridge Dr., Apt. 2B, Mission, KS, 66202, USA</td></tr><tr><td colspan="2" class="item-abstract">Home health care is the provision of skilled and/or personal care services in the home, which are provided directly, delegated, or coordinated primarily by nurses. The purpose of this study was to describe and analyze how average resource use relates to patient outcomes after controlling for case mix (patient characteristics). The study was framed using Donbedian's Structure-Process-Outcome Model for Quality Assessment. Resource use, a process indicator, was measured as the average number of visits and cost per patient. The outcomes included agency rates for hospitalization, discharged and remaining in the community, emergent care, and improvement in bathing, ambulation, and medication management. The study design was retrospective observational with secondary analysis of case mix and outcomes data from the Outcome and Assessment Information Set and resource use from FY99 Medicare cost reports. A diverse, nonrandom sample of 277 home health agencies met the inclusion criteria. Multiple regression analysis and risk adjustment procedures were used with the agency as the unit of analysis. Agency case mix (patient characteristics) explained large amounts of the variation in the outcomes across agencies (20% for improved ambulation to 61% for discharged in the community). Resource use and outcomes were correlated, indicating higher resource use was associated with poorer outcomes. However, after controlling for case mix, resource use did not contribute to explained variance of the functional outcomes and only marginally contributed to explained variance in agency rates for hospitalization and discharged in the community. It is important not to conclude there is no relationship between resource use and outcomes. One implication is that average resource use may not be as important as the mix of services and the appropriateness of the care processes in determining outcomes. Therefore, for the range of resource use and outcomes examined, agencies possibly could improve outcomes without necessarily increasing cost. AN: MN030311</td></tr></table>en_GB
dc.date.available2011-10-26T21:58:20Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:58:20Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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