The effectiveness of home health care for reducing readmissions: an integrative review

Siclovan, Danielle M.

doi:10.1080/01621424.2018.1472702

Cited by 9 publications

(5 citation statements)

References 62 publications

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“…Our recent study also found that HHC visits may reduce the need for early readmission after coronary artery bypass grafting [22]. Not all studies have found protective effect of HHC on readmission; however [3,23–25], while we demonstrate that HHC reduces readmission rates in AMI patients, Sud et al . [3] recently explored readmissions in AMI, focusing on patients with ST-elevation myocardial infarction with cardiogenic shock.…”

Section: Discussionsupporting

confidence: 67%

Home health care after discharge is associated with lower readmission rates for patients with acute myocardial infarction

Sheikh

Ngendahimana

Deo

et al. 2021

Coronary Artery Disease

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Objective We studied the utilization of home health care (HHC) among acute myocardial infarction (AMI) patients, impact of HHC on and predictors of 30-day readmission. Methods We queried the National Readmission Database (NRD) from 2012 to 2014identify patients with AMI discharged home with (HHC+) and without HHC (HHC−). Linkage provided in the data identified patients who had 30-day readmission, our primary end-point. The probability for each patient to receive HHC was calculated by a multivariable logistic regression. Average treatment of treated weights were derived from propensity scores. Weight-adjusted logistic regression was used to determine impact of HHC on readmission. Results A total of 406 237 patients with AMI were discharged home. Patients in the HHC+ cohort (38 215 patients, 9.4%) were older (mean age 77 vs. 60 years P < 0.001), more likely women (53 vs. 26%, P < 0.001), have heart failure (5 vs. 0.5%, P < 0.001), chronic kidney disease (26 vs. 6%, P < 0.001) and diabetes (35 vs. 26%, P < 0.001). Patients readmitted within 30-days were older with higher rates of diabetes (RR = 1.4, 95% CI: 1.37–1.48) and heart failure (RR = 5.8, 95% CI: 5.5–6.2). Unadjusted 30-day readmission rates were 21 and 8% for HHC+ and HHC− patients, respectively. After adjustment, readmission was lower with HHC (21 vs. 24%, RR = 0.89, 95% CI: 0.82–0.96; P < 0.001). Conclusion In the United States, AMI patients receiving HHC are older and have more comorbidities; however, HHC was associated with a lower 30-day readmission rate.

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Section: Discussionsupporting

confidence: 67%

Home health care after discharge is associated with lower readmission rates for patients with acute myocardial infarction

Sheikh

Ngendahimana

Deo

et al. 2021

Coronary Artery Disease

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“…Non-skilled services primarily refer to the homemaking assistance provided by home health aids (HA) [17]. HH has been shown to delay nursing home admission in older adults with dementia [18][19][20][21][22][23][24], because it reduces cognitive impairment and functional limitations, the two strongest predictors of nursing home admission [25,26].…”

Section: Introductionmentioning

confidence: 99%

Functional outcome in home health: Do racial and ethnic minority patients with dementia fare worse?

Wang

Cai

et al. 2020

PLoS ONE

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ObjectivesEvaluate the independent and interactive effects of dementia and racial/ethnic minority status on functional outcomes during a home health (HH) admission among Medicare beneficiaries. MethodsSecondary analysis of data from the Outcome and Assessment Information Set [OASIS] and billing records in a non-profit HH agency in New York. Participants were adults � 65 years old who received HH in CY 2017 with OASIS records at HH admission and HH discharge. Dementia was identified by diagnosis (ICD-10 codes) and cognitive impairment (OASIS: M1700, M1710, M1740). We used OASIS records to assess race/ethnicity (M0140) and functional status (M1800-M1870 on activities of daily living [ADL]). Functional outcome was measured as change in the composite ADL score from HH admission to HH discharge, where a negative score means improvement and a positive score means decline. ResultsThe sample included 4,783 patients, among whom 93.9% improved in ADLs at HH discharge. In multivariable linear regression that adjusted for HH service use and covariates (R 2 = 0.23), being African American (β = 0.21, 95% confidence interval [CI]: 0.06, 0.35, p = 0.005) and having dementia (β = 0.51, 95% CI: 0.41, 0.62, p<0.001) were independently related to less ADL improvement at HH discharge, with significant interaction related to further decrease in ADL improvement. Relative to white patients without dementia, African American patients with dementia (β = 1.08, 95% CI: 0.81, 1.35, p<0.001), Hispanics with

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“…reported higher rate of readmission among HHC patients compared to patients without HHC. [ 11 ] They also defined three confounding factors relating HHC to readmissions (HHC eligibility criteria, variation in practice referral and some characteristics of patients that may cause the likelihood to be admitted again). There was no such difference seen in our patient sample.…”

Section: Discussionmentioning

confidence: 99%

Immediate outcome assessment of the rapid response team of home health care services at King Abdulaziz Medical City in Riyadh

Masud

Bawazeer

Alsowailmi

et al. 2023

Journal of Family Medicine and Primary Care

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A BSTRACT Background: Paediatrics rapid response team (RRT) is a newly developed service under paediatrics home health care (HHC) programme which is a standby visiting team that responds to non-critical emergency calls. The current study aimed to compare the total emergency visits and hospital admissions before and after implementation of RRT project. Method: A retrospective chart review was conducted from December 2018 to December 2020. Paediatric patients registered under the home health care (HHC) programme were the target population. The admission and hospitalization rates were assessed before and after the implantation of an RRT. The variables related to patient profile were assessed to explore the association between hospitalization and admission. Result: Data for 117 patients and a total of 114 calls attended under HHC covered by RRT were analysed. In the first year after the implementation of RRT, the mean number of ER visits per patient per year was reduced from 4.78 ± 6.10 to 3.93 ± 4.12 with ( P value, 0.06). Also, a slight decrease in the mean number of admissions from 3.74 ± 4.43 to a mean of 3.46 ± 4.1 with ( P value, 0.29). Follow-up after receiving an RRT call for an initial complaint was statistically significant in reducing both ER visits and hospital admissions within 7 days with a P value of 0.03 and 0.04, respectively. Conclusion: The RRT was effective in decreasing the ER visits and hospital admissions for a very special group of patients. Additionally, the emplacement of proper triaging code at the time of attending to patients helped in reducing unnecessary ER visit and hospital admission.

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The effectiveness of home health care for reducing readmissions: an integrative review

Cited by 9 publications

References 62 publications

Home health care after discharge is associated with lower readmission rates for patients with acute myocardial infarction

Home health care after discharge is associated with lower readmission rates for patients with acute myocardial infarction

Functional outcome in home health: Do racial and ethnic minority patients with dementia fare worse?

Immediate outcome assessment of the rapid response team of home health care services at King Abdulaziz Medical City in Riyadh

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