Home-Based Care Provider Perspectives on Care Refusal During the COVID-19 Pandemic

Inloes, Jennifer B; Brown, Allyson; Rettell, Zoe; Fick, Donna M.; Bell, Sue Anne

doi:10.3928/00989134-20221206-02

Cited by 1 publication

(1 citation statement)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ambulatory care sites shifting to telemedicine left many patients receiving HH services unable to access in‐person primary care. Some HH agencies limited in‐person visits due to lack of personal protective equipment (PPE) and patient refusal of services 4,5 . HH workforce availability was problematic, with HH aides caring for their own ill family members or falling ill themselves; HH agencies made massive operational shifts and implemented strategies to balance in‐person and remote visits without guarantee of reimbursement.…”

Section: Introductionmentioning

confidence: 99%

Characterizing changes to older adults' care transition patterns from hospital to home care in the initial year of COVID‐19

Arbaje,

Hsu,

Zhou

et al. 2024

J American Geriatrics Society

View full text Add to dashboard Cite

BackgroundSkilled home healthcare (HH) provided in‐person care to older adults during the COVID‐19 pandemic, yet little is known about the pandemic's impact on HH care transition patterns. We investigated pandemic impact on (1) HH service volume; (2) population characteristics; and (3) care transition patterns for older adults receiving HH services after hospital or skilled nursing facility (SNF) discharge.MethodsRetrospective, cohort, comparative study of recently hospitalized older adults (≥ 65 years) receiving HH services after hospital or SNF discharge at two large HH agencies in Baltimore and New York City (NYC) 1‐year pre‐ and 1‐year post‐pandemic onset. We used the Outcome and Assessment Information Set (OASIS) and service use records to examine HH utilization, patient characteristics, visit timeliness, medication issues, and 30‐day emergency department (ED) visit and rehospitalization.ResultsAcross sites, admissions to HH declined by 23% in the pandemic's first year. Compared to the year prior, older adults receiving HH services during the first year of the pandemic were more likely to be younger, have worse mental, respiratory, and functional status in some areas, and be assessed by HH providers as having higher risk of rehospitalization. Thirty‐day rehospitalization rates were lower during the first year of the pandemic. COVID‐positive HH patients had lower odds of 30‐day ED visit or rehospitalization. At the NYC site, extended duration between discharge and first HH visit was associated with reduced 30‐day ED visit or rehospitalization.ConclusionsHH patient characteristics and utilization were distinct in Baltimore versus NYC in the initial year of the COVID‐19 pandemic. Study findings suggest some older adults who needed HH may not have received it, since the decrease in HH services occurred as SNF use decreased nationally. Findings demonstrate the importance of understanding HH agency responsiveness during public health emergencies to ensure older adults' access to care.

show abstract

Section: Introductionmentioning

confidence: 99%