A Qualitative Study of Choosing Home Health Care After Hospitalization: The Unintended Consequences of ‘Patient Choice’ Requirements

Baier, Rosa R.; Wysocki, Andrea; Gravenstein, Stefan; Cooper, Emily; Mor, Vincent; Clark, Melissa A.

doi:10.1007/s11606-014-3164-7

Cited by 21 publications

(40 citation statements)

References 13 publications

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“…The present study sought to do so and found that patients (and their families) felt that hospital staff were minimally involved and that they would have appreciated more help. This is consistent with existing literature, which has found that home health case managers do not provide quality information or make recommendations but merely provide lists of agency names and contact information . It is also consistent with research that has highlighted the importance of providing information to patients because consumer understanding of postacute services is associated with decision‐making .…”

Section: Discussionsupporting

confidence: 88%

“…This is consistent with existing literature, which has found that home health case managers do not provide quality information or make recommendations but merely provide lists of agency names and contact information. 27 It is also consistent with research that has highlighted the importance of providing information to patients because consumer understanding of postacute services is associated with decision-making. 9,28 In the present study, respondents reported feeling that medical staff were not allowed to offer guidance or recommendations, even though most nursing home admissions come from the hospital and hospital discharge planners are key stakeholders in the placement process.…”

Section: Discussionsupporting

confidence: 79%

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Selecting a Skilled Nursing Facility for Postacute Care: Individual and Family Perspectives

Gadbois

Tyler

Mor

2017

J American Geriatrics Society

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Background/Objectives This research seeks to describe patients' experiences during the hospital discharge planning and skilled nursing facility (SNF) selection process. Design Semi-structured interviews, focusing on discharge planning and nursing facility selection, including how facilities were chosen, who was involved, and what factors were important in decision-making. Setting 14 SNFs in five cities across the United States. Participants 98 newly-admitted, previously community-dwelling SNF patients and/or their family members. Measurement Semi-structured interviews were qualitatively coded to identify underlying themes. Results Most respondents reported receiving only a list of SNF names and addresses from discharge planners and that hospital staff were minimally involved. Patients' choice of SNF was most often influenced by proximity to home and prior experience with the facility. Most respondents reported being satisfied with their placement, although many stated that they would have been willing to travel further to another SNF were it recommended. Many reported feeling rushed and unprepared, stating that they did not know where or how to get help. Conclusion SNF placement is a stressful transition, occurring when patients are physically vulnerable and with limited guidance from discharge planners. Therefore, most patients select a facility based on its location, perhaps because they are provided with no other information. Given CMS's proposed changes to the discharge planning process, this research highlights the value of providing patients and family caregivers with both quality data and assistance in interpreting it.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 79%

Selecting a Skilled Nursing Facility for Postacute Care: Individual and Family Perspectives

Gadbois

Tyler

Mor

2017

J American Geriatrics Society

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“…Case managers reported that this was primarily because they did not have the information necessary to identify better quality agencies and also because they felt that federal law regarding patient choice prohibited them from doing so. 15 …”

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confidence: 99%

Patients Are Not Given Quality-Of-Care Data About Skilled Nursing Facilities When Discharged From Hospitals

et al. 2017

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Hospitals are now being held at least partly accountable for Medicare patients’ care after discharge, as a result of regulations and incentives imposed by the Affordable Care Act. However, little is known about how patients select a postacute care facility. We used a multiple case study approach to explore both how patients requiring postacute care decide which skilled nursing facility to select and the role of hospital staff members in this decision. We interviewed 138 staff members of sixteen hospitals and twenty-five skilled nursing facilities and 98 patients in fourteen of the skilled nursing facilities. Most patients described receiving only lists of skilled nursing facilities from hospital staff members, while staff members reported not sharing data about facilities’ quality with patients because they believed that patient choice regulations precluded them from doing so. Consequently, patients’ choices were rarely based on readily available quality data. Proposed changes to the Medicare conditions of participation for hospitals that pertain to discharge planning could rectify this problem. In addition, less strict interpretations of choice requirements would give hospitals flexibility in the discharge planning process and allow them to refer patients to higher-quality facilities.

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“…Patient decisions for choosing a hospital are influenced by a prior use of health services in that hospital and patient-to-hospital distance [17]. Public reports can be considered as tools which managers can use to help patients differentiate among providers [18]. The results show that relative to self-pay patients, Government and Labor Health Insurance beneficiaries and high-income patients are more likely to use county hospitals, while patients covered by the rural Cooperative Medical System (CMS) are more likely to use village-level facilities.…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting Preferences of Primigravida Women for Choosing a Public Hospital

Zalzar

Alimohammadzadeh

2015

ijtmgh

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Introduction: Finding the factors affecting patients ' tendency to a hospital, can improve the health system. The purpose of this study was to recognize the factors affecting primigravidas ' preferences to select a public hospital, in order to determine the correlation on these preferences. Methods: In this cross-sectional study, 220 primigravida women who had admitted for delivery or cesarean in the Kamali public hospital in Karaj were selected using random sampling in 2014. Data collected by semi-structured questionnaire were analyzed by using structural equation modeling method and Lisrel Software. Results: Among the six studied indicators (services, processes, providers, cost, advertisements, and place), the most effective factor was the type of service (regression weight 0.89), and the lowest effective factor was services ' cost (regression weight 0.64). Moreover, providers and services had the most correlation and processes and services cost had the least correlation. Conclusion: The clients ' requests must be considered to improve the quality and quantity of services and processes. Authorities should try to solve medical problems and provide medical facilities and welfare in hospitals in order to attract clients' confidence.

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A Qualitative Study of Choosing Home Health Care After Hospitalization: The Unintended Consequences of ‘Patient Choice’ Requirements

Cited by 21 publications

References 13 publications

Selecting a Skilled Nursing Facility for Postacute Care: Individual and Family Perspectives

Selecting a Skilled Nursing Facility for Postacute Care: Individual and Family Perspectives

Patients Are Not Given Quality-Of-Care Data About Skilled Nursing Facilities When Discharged From Hospitals

Factors Affecting Preferences of Primigravida Women for Choosing a Public Hospital

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