National Healthcare Quality and Disparities Report
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Topics
- Cardiovascular Conditions (2)
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- Communication (1)
- Comparative Effectiveness (1)
- Cultural Competence (1)
- Dementia (1)
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- Health Services Research (HSR) (1)
- Heart Disease and Health (3)
- (-) Home Healthcare (12)
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- (-) Hospital Readmissions (12)
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- Patient-Centered Outcomes Research (1)
- Pneumonia (1)
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- Risk (1)
- Transitions of Care (4)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 12 of 12 Research Studies DisplayedSquires A, Engel P, Ma C
Continuity of care versus language concordance as an intervention to reduce hospital readmissions from home health care.
The purpose of this study was to examine the relative effectiveness of continuity of care and language concordance as alternative or complementary interventions to improve health outcomes of people with limited English proficiency. Participants included over 22,000 non-English-speaking patients from the New York City area who were admitted to their home health site following hospital discharge. Findings revealed that high continuity of care and high language concordance significantly decreased readmissions, along with high continuity of care and low language concordance; low continuity of care and high language concordance did not significantly impact readmissions. The authors concluded that enhancing continuity of care for those with language barriers the US home health system may help to address disparities and reduce hospital readmission rates.
AHRQ-funded; HS023593.
Citation: Squires A, Engel P, Ma C .
Continuity of care versus language concordance as an intervention to reduce hospital readmissions from home health care.
Med Care 2023 Sep; 61(9):605-10. doi: 10.1097/mlr.0000000000001884..
Keywords: Hospital Readmissions, Transitions of Care, Home Healthcare
Squires A, Ma C, Miner S
Assessing the influence of patient language preference on 30 day hospital readmission risk from home health care: a retrospective analysis.
In home health care, language barriers are understudied. Language barriers between patients and providers are known to affect a variety of patient outcomes. How a patient's language preference influences hospital readmission risk from home health care has yet to be determined. The objective of this retrospective cross-sectional study was to determine if home care patients' language preference is associated with their risk for hospital readmission from home health care within 30 days of hospital discharge.
AHRQ-funded; HS023593.
Citation: Squires A, Ma C, Miner S .
Assessing the influence of patient language preference on 30 day hospital readmission risk from home health care: a retrospective analysis.
Int J Nurs Stud 2022 Jan;125:104093. doi: 10.1016/j.ijnurstu.2021.104093..
Keywords: Cultural Competence, Home Healthcare, Hospital Readmissions, Risk, Communication
Ma C, McDonald MV, Feldman PH
Continuity of nursing care in home health: impact on rehospitalization among older adults with dementia.
The objective of this retrospective cohort study was to examine the association between continuity of nursing care in home health care (HHC) and rehospitalization among persons with dementia (PWD). Multiple years of HHC assessment, administrative, and human resources data from a large urban not-for-profit home health agency was used. Findings showed that wide variations exist in continuity of nursing care to PWD. Consistency in nurse staff when providing HHC visits to PWD is critical for preventing rehospitalizations.
AHRQ-funded; HS023593.
Citation: Ma C, McDonald MV, Feldman PH .
Continuity of nursing care in home health: impact on rehospitalization among older adults with dementia.
Med Care 2021 Oct;59(10):913-20. doi: 10.1097/mlr.0000000000001599..
Keywords: Elderly, Home Healthcare, Dementia, Neurological Disorders, Hospital Readmissions
Smith JM, Lin H, Thomas-Hawkins C
Timing of home health care initiation and 30-day rehospitalizations among Medicare beneficiaries with diabetes by race and ethnicity.
Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization admission during 2015.
AHRQ-funded; HS022406.
Citation: Smith JM, Lin H, Thomas-Hawkins C .
Timing of home health care initiation and 30-day rehospitalizations among Medicare beneficiaries with diabetes by race and ethnicity.
Int J Environ Res Public Health 2021 May 25;18(11). doi: 10.3390/ijerph18115623..
Keywords: Elderly, Home Healthcare, Hospital Readmissions, Medicare, Diabetes, Chronic Conditions, Racial and Ethnic Minorities
Misra-Hebert AD, Rothberg MB, Fox J
Healthcare utilization and patient and provider experience with a home visit program for patients discharged from the hospital at high risk for readmission.
This retrospective cohort study assessed the association of home visits by advanced practice registered nurses (APRNs) and paramedics with healthcare utilization and mortality of patients released home after hospital discharge The authors looked at adult medical patients discharged to home from November 2017-September 2019. They assessed outcomes for home visit vs. matched comparison patients at 30, 90, and 180 days, including hospital admission, emergency department (ED) use, and death using two phases. Phase 1 was defined as APRN or paramedic visits assigned by geographic location and Phase 2 defined as APRN and paramedic visit teams assigned to patients. They also compared patients who declined home visits with those accepting them. Phase 1 outcomes showed no differences in readmissions, ED visits, or death at 30,90, and 180 days. Phase 2 showed patients who had home visits had fewer 30-day readmissions and no differences in other outcomes. Patients who accepted home visits had lower odds of readmission compared to patients who declined. Forty-four interviews were also conducted, and themes of Medication Understanding, Knowledge Gap after Discharge, Patient Medical Complexity, Social Context, and Patient Engagement/Need for Reassurance emerged.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Rothberg MB, Fox J .
Healthcare utilization and patient and provider experience with a home visit program for patients discharged from the hospital at high risk for readmission.
Healthc 2021 Mar;9(1):100518. doi: 10.1016/j.hjdsi.2020.100518..
Keywords: Home Healthcare, Transitions of Care, Hospital Discharge, Hospital Readmissions
Weerahandi H, Bao H, Herrin J
Home health care after skilled nursing facility discharge following heart failure hospitalization.
Heart failure (HF) readmission rates have plateaued despite scrutiny of hospital discharge practices. Many HF patients are discharged to skilled nursing facility (SNF) after hospitalization before returning home. Home healthcare (HHC) services received during the additional transition from SNF to home may affect readmission risk. In this study, the investigators examined whether receipt of HHC affects readmission risk during the transition from SNF to home following HF hospitalization.
AHRQ-funded; HS022882.
Citation: Weerahandi H, Bao H, Herrin J .
Home health care after skilled nursing facility discharge following heart failure hospitalization.
J Am Geriatr Soc 2020 Jan;68(1):96-102. doi: 10.1111/jgs.16179..
Keywords: Home Healthcare, Nursing Homes, Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Hospital Readmissions, Transitions of Care, Elderly
Jones CD, Falvey J, Hess E
Predicting hospital readmissions from home healthcare in Medicare beneficiaries.
The authors used patient-level clinical variables to develop and validate a parsimonious model to predict hospital readmissions from home healthcare (HHC) in Medicare fee-for-service beneficiaries. They found that variables available to HHC clinicians at the first post-discharge HHC visit can predict readmission risk and inform care plans in HHC. They recommend that future analyses incorporating measures of social determinants of health, such as housing instability or social support, have the potential to enhance prediction of this outcome.
AHRQ-funded; HS024569.
Citation: Jones CD, Falvey J, Hess E .
Predicting hospital readmissions from home healthcare in Medicare beneficiaries.
J Am Geriatr Soc 2019 Dec;67(12):2505-10. doi: 10.1111/jgs.16153..
Keywords: Home Healthcare, Hospital Readmissions, Medicare, Elderly, Transitions of Care
Popescu I, Sood N, Joshi S
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Medicare's Hospital Readmission Reduction Program penalizes hospitals with elevated 30-day readmission rates for acute myocardial infarction, heart failure, or pneumonia. The authors investigated if, in order to reduce readmissions, hospitals may have increased referrals to skilled nursing facilities and home health care. They found that hospitals might be shifting to more intensive postacute care to avoid readmissions among seniors with pneumonia. At the same time, penalized hospitals' efforts to prevent readmissions may be keeping higher proportions of their patients in the community.
AHRQ-funded; HS024284; HS025394.
Citation: Popescu I, Sood N, Joshi S .
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Med Care 2019 Oct;57(10):757-65. doi: 10.1097/mlr.0000000000001184..
Keywords: Home Healthcare, Nursing Homes, Chronic Conditions, Hospital Readmissions, Long-Term Care, Hospitals, Heart Disease and Health, Pneumonia, Cardiovascular Conditions
Ma C, Shang J, Miner S
The prevalence, reasons, and risk factors for hospital readmissions among home health care patients: a systematic review.
This systematic review examined the current evidence about hospital readmissions from home health care (HHC). Among 18 reviewed articles, they found that reported readmission rates and risk factors varied dramatically between studies; reasons for readmissions were understudied; and findings were limited by small sample sizes, single data source, and methodological flaws. They recommended that future studies use multiple national data sources across patients’ care spectrum and advanced statistical models to identify who among HHC patients are most likely to be readmitted to hospital and for what reason.
AHRQ-funded; HS023593.
Citation: Ma C, Shang J, Miner S .
The prevalence, reasons, and risk factors for hospital readmissions among home health care patients: a systematic review.
Home Health Care Manag Pract 2018 May;30(2):83-92.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Home Healthcare, Hospital Readmissions
Murtaugh CM, Deb P, Zhu C
Reducing readmissions among heart failure patients discharged to home health care: effectiveness of early and intensive nursing services and early physician follow-up.
This study compared the effectiveness of two "treatments"-early, intensive home health nursing and physician follow-up within a week-versus less intense and later postacute care in reducing readmissions among heart failure patients discharged to home health care. Neither treatment by itself had a statistically significant effect on hospital readmission. In combination, however, they reduced the probability of readmission by roughly 8 percentage points.
AHRQ-funded; HS020257.
Citation: Murtaugh CM, Deb P, Zhu C .
Reducing readmissions among heart failure patients discharged to home health care: effectiveness of early and intensive nursing services and early physician follow-up.
Health Serv Res 2017 Aug;52(4):1445-72. doi: 10.1111/1475-6773.12537.
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Keywords: Comparative Effectiveness, Heart Disease and Health, Home Healthcare, Hospital Readmissions, Patient-Centered Outcomes Research
Wang Y, Pandolfi MM, Fine J
Community level association between home health and nursing home performance on quality and hospital 30-day readmissions for Medicare patients.
Using CMS data from 2010 to 2012, the researchers evaluated whether community-level home health agencies and nursing home performance is associated with community-level hospital 30-day all-cause risk-standardized readmission rates for Medicare patients. They found that increasing nursing home performance by one star for all of its 4 measures and home health performance by 10 points for all of its 6 measures is associated with decreases in community-level risk-standardized readmission rates.
AHRQ-funded; HS023000.
Citation: Wang Y, Pandolfi MM, Fine J .
Community level association between home health and nursing home performance on quality and hospital 30-day readmissions for Medicare patients.
Home Health Care Manag Pract 2016 Nov;28(4):201-08. doi: 10.1177/1084822316639032.
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Keywords: Quality of Care, Hospital Readmissions, Home Healthcare, Nursing Homes, Provider Performance
Jubelt LE, Goldfeld KS, Chung WY
Changes in discharge location and readmission rates under Medicare bundled payment.
To control costs, NYU Langone Medical Center attempted to shift referrals from facility-based to home-based postacute care. In the context of this shift in referrals, the researchers examined the change in hospital readmission rates. Their findings suggest that institutions may be able to shift some patients from facility-based to home-based postacute care without adversely affecting hospital readmission rates or the length of hospital stay.
AHRQ-funded; HS023683; HS022882.
Citation: Jubelt LE, Goldfeld KS, Chung WY .
Changes in discharge location and readmission rates under Medicare bundled payment.
JAMA Intern Med 2016 Jan;176(1):115-7. doi: 10.1001/jamainternmed.2015.6265.
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Keywords: Medicare, Hospital Discharge, Hospital Readmissions, Home Healthcare, Healthcare Costs