Home care following hospitalization of elderly rural patients with chronic diseases: Evaluation of changes in perceived health status on fluctuations in utilization and cost of formal and informal services

2.50
Hdl Handle:
http://hdl.handle.net/10755/166211
Category:
Abstract
Type:
Presentation
Title:
Home care following hospitalization of elderly rural patients with chronic diseases: Evaluation of changes in perceived health status on fluctuations in utilization and cost of formal and informal services
Author(s):
Griggs, Marcella
Author Details:
Marcella Griggs, PhD, Radford University School of Nursing, Radford, Virginia, USA, email: mgriggs@runet.edu
Abstract:
Policy efforts to control costs mean that an appropriate balance between formal and informal caregiving systems must be created, but few studies have examined the costs associated with caring for chronically-ill older adults in their homes. Research questions addressed: 1) whether Global Health Status and Functional Health Status values change over the course of an illness episode for both patients and in-home primary caregivers; 2) whether Burden of Care values change for caregivers during the course of an illness episode; and, 3) whether Formal and Informal Service Utilization and Cost Distributions differ between groups of patients who get better and those who get worse during the course of an illness episode. A comparative prospective panel design was used to interview a sample of 21 chronically-ill patients and their 21 primary caregivers on admission to a Medicare-certified home health care agency, at termination of skilled services, and 30 days after discharge. Health status measures included the Sickness Impact Profile, ADLs, IADLs, and Burden of Care. Formal services and costs were evaluated using visits made and charges billed to Medicare and/or Medicaid. Informal services and costs were evaluated using hours of assistance provided with ADLs and IADLs and regional hourly wage rates. The data were analyzed using within-subjects repeated measures ANOVAs. Health status of patients changed significantly across time, with patients who got better showing improved health status but continued difficulty with ADLs and IADLs. Burden of Care did not change significantly over time. Formal service costs were higher for patients who got worse compared to those who got better. Patients received 4.4 mean hours of informal services per day. Intensity of informal services was greater during initial home care services; however, intensity remained the same and did not change for those who got worse. The average cost per patient day was $47 for formal services and $44 for informal services. This study revealed a highly impaired patient group with dedicated informal caregivers spending an average of 31 hours each week helping with ADLs and IADLs in addition to the visits made by formal service providers. The findings from this study have importance for public policy and clinical practice with regard to forging realistic linkages between both the formal and informal support systems as patients move from one provider system to the next.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
Feb 29 - Mar 2, 1996
Conference Host:
Southern Nursing Research Society
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleHome care following hospitalization of elderly rural patients with chronic diseases: Evaluation of changes in perceived health status on fluctuations in utilization and cost of formal and informal servicesen_GB
dc.contributor.authorGriggs, Marcellaen_US
dc.author.detailsMarcella Griggs, PhD, Radford University School of Nursing, Radford, Virginia, USA, email: mgriggs@runet.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/166211-
dc.description.abstractPolicy efforts to control costs mean that an appropriate balance between formal and informal caregiving systems must be created, but few studies have examined the costs associated with caring for chronically-ill older adults in their homes. Research questions addressed: 1) whether Global Health Status and Functional Health Status values change over the course of an illness episode for both patients and in-home primary caregivers; 2) whether Burden of Care values change for caregivers during the course of an illness episode; and, 3) whether Formal and Informal Service Utilization and Cost Distributions differ between groups of patients who get better and those who get worse during the course of an illness episode. A comparative prospective panel design was used to interview a sample of 21 chronically-ill patients and their 21 primary caregivers on admission to a Medicare-certified home health care agency, at termination of skilled services, and 30 days after discharge. Health status measures included the Sickness Impact Profile, ADLs, IADLs, and Burden of Care. Formal services and costs were evaluated using visits made and charges billed to Medicare and/or Medicaid. Informal services and costs were evaluated using hours of assistance provided with ADLs and IADLs and regional hourly wage rates. The data were analyzed using within-subjects repeated measures ANOVAs. Health status of patients changed significantly across time, with patients who got better showing improved health status but continued difficulty with ADLs and IADLs. Burden of Care did not change significantly over time. Formal service costs were higher for patients who got worse compared to those who got better. Patients received 4.4 mean hours of informal services per day. Intensity of informal services was greater during initial home care services; however, intensity remained the same and did not change for those who got worse. The average cost per patient day was $47 for formal services and $44 for informal services. This study revealed a highly impaired patient group with dedicated informal caregivers spending an average of 31 hours each week helping with ADLs and IADLs in addition to the visits made by formal service providers. The findings from this study have importance for public policy and clinical practice with regard to forging realistic linkages between both the formal and informal support systems as patients move from one provider system to the next.en_GB
dc.date.available2011-10-27T14:42:32Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:42:32Z-
dc.conference.dateFeb 29 - Mar 2, 1996en_US
dc.conference.hostSouthern Nursing Research Societyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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