Determinants of Home Care Nursing Hours for Technology‐Assisted Children

Abstract

In the 1980s home care, in contrast to hospital care, was reported substantially to reduce costs for third-party payers who provided funding for technology-assisted children. Savings were realized primarily because parents substituted for nurses, eliminating or reducing those costs. Third-party payers' savings thus were directly related to the number of hours parents assumed care. Because home care relies on parents doing some of the work of nurses, decisions regarding nursing hours must consider family factors in addition to medical factors. We evaluated the number of nursing hours 31 Minnesota families with technology-assisted children received, as well as the factors that determined the allotment of nursing hours. Most families (96.8%) received some hours of nursing hours. Most families (96.8%) received some hours of professional nursing care per day, and 16.1% received 24-hour care. Multiple regression, however, showed that family factors, rather than the child's medical condition, influenced the number of hours, with married, lower-income families with a younger child receiving the fewest. Further discussion and study are recommended to understand more fully the impact family factors have on the allotment of nursing hours and home care costs.

The Relationship Between Demographic Characteristics and Nursing Problems in Home Health Care

“…Living arrangements are an important predictor of type of home care used (Day, 1984): those who live with others use fewer aide services than those who live alone. Similarly, family factors, rather than the health needs of technology-assisted children, were most closely related to the number of hours of home care the children received (Leonard, Brust, & Sielaff, 1991). Younger children whose parents were married and had lower incomes received the fewest services.…”

Discharge Before Return to Respiratory Baseline in Children with Neurologic Impairment

“…Home nurses can assist families in providing increased respiratory support and recognizing respiratory problems that may arise following discharge. However, home nursing shortages are common nationwide 31,32 . Low‐income children, children with respiratory technology use, and children without Medicaid have been found to have larger gaps in home nursing availability 31,32 .…”

“…However, home nursing shortages are common nationwide. 31,32 Low-income children, children with respiratory technology use, and children without Medicaid have been found to have larger gaps in home nursing availability. 31,32 Further studies are needed to understand the role of home nursing availability in provider discharge decisions in this population.…”

Factors influencing home care nursing problems and nursing care

“…In this study, predictors of nursing problems and use focused on a single visit. Other home health researchers have focused on the total amount of home health services used, factors that affect patients' differential use of home health services, changes in home health service use patterns following an event, and descriptions of patients who use versus those who do not use home health services (Ballard & McNamara, 1983;Easton, Cogen, Fulcomer, 1991;Frederiks et al, 1992;Gornick & Hall, 1988;Kemper, 1992;Kornblatt, Fisher, & MacMillan, 1985;Leonard, Brust, & Sielaff, 1991). Thus, future work should clarify differences in results based on the ways the term "use of home health services" has been conceptualized.…”