Continuity in Home Health Care: Is Consistency in Nursing Personnel Associated with Better Patient Outcomes?

Abstract

A growing body of evidence suggests that patients who receive coordinated and uninterrupted health care services have better outcomes, more efficient resource utilization, and lower costs of health care. However, limited research has considered whether attributes of continuity in home health care service delivery are associated with improved patient outcomes. The present study examines the relationship between one dimension of continuity of care, consistency in nursing personnel, and three patient outcomes: hospitalization, emergent care, and improvement in activities of daily living. Analyses of data from a large population of home health patients (N=59,854) suggest that greater consistency in nursing personnel decreases the probability of hospitalization and emergent care, and increases the likelihood of improved functioning in activities of daily living between admission and discharge from home health care. These results provide preliminary evidence that efforts to decrease dispersion of nursing personnel across a series of home visits to patients may lead to improved outcomes. The implications of these findings for clinical practice and further research are discussed in the paper.

Associations between nursing home performance and hospital 30‐day readmissions for acute myocardial infarction, heart failure and pneumonia at the healthcare community level in the United States

“…Our results extend previous studies (Unroe et al, 2012;Allen et al, 2011;Ogunneye, 2014;Sandvik et al, 2013;Russell et al, 2011;Veilleux et al, 2014;Tuso et al, 2014;Neuman et al, F I G U R E 1 Flow chart demonstrating how the study sample was determined F I G U R E 2 Distribution of nursing homes by the composite star rating score. The composite score of the aggregated four measures showed approximately 67% of nursing homes were in a range of greater than two stars and less than four stars and 20% were in a range of greater than four stars | 5 of 10 2014), which focused on the association between nursing home performance and hospital readmissions at the patient level.…”

“…Previous studies have shown that nursing home performance may play an important role in hospital readmissions (Unroe, Greiner, Colón-Emeric, Peterson, & Curtis, 2012;Allen et al, 2011;Ogunneye et al, 2014;Sandvik, Bade, Dunham, & Hendrickson, 2013;Russell, Rosati, Rosenfeld, & Marren, 2011;Veilleux, Wight, Cannon, Whalen, & Bachman, 2014;Tuso et al, 2014;Neuman, Wirtalla, & Werner, 2014).…”

Continuity of care in home health-care practice: two management paradoxes

“…According to the managers, limiting the number of carers was a prerequisite for achieving continuity of care; interpersonal continuity appeared to be an ideal. It is a common presumption that patients prefer consistency of carers (Haggerty et al 2003, Woodward et al 2004, McLeod 2011 and it is also presumed that carer consistency enables quality care (Russell et al 2011). Experiencing continuity of care may also have a positive effect on the patientÕs psychosocial wellbeing (DÕErrico 2006).…”

Home Health Agency Performance in the United States: 2011–15

“…13,[19][20][21] Prior studies have largely focused on home health care use and services. [22][23][24][25][26][27][28] Although these studies have shown that rural areas used home health care services less frequently and that a single agency was more likely to serve areas in the Midwest and West, [22][23][24][25] it is largely unknown how much geographic variation there is in quality of agency performance. There could be regional contextual influences that lead to regional variation in addition to variation between individual agencies.…”