Cooperating for better care.

home healthcare

Tag Archives

Home healthcare mismatch

From HealthAffairs:

“As many as four million U.S. residents need home-based medical care, and there is a shortage of willing providers. Nengliang (Aaron) Yao of the University of Virginia School of Medicine and coauthors used 2012–13 Medicare fee-for-service data and found that 9 percent of the 5,000 primary care providers performed 44 percent of the 1.7 million home visits that year . The authors also determined that the majority of Americans live more than 30 miles from a home-based medical care provider.

“The data, the authors note, suggest a mismatch between the medical needs of homebound older adults and the ability of the medical system to provide care for them where they need to be served. This is one of the first descriptions of the provision and use of U.S. home-based medical care and sets a baseline for future evaluation of workforce and geographic variations in its composition and use.”

Hit this link to see the map with this article.

Post-acute care as substitute for inpatient care?


Some hospitals might be using post-acute care as a substitute for inpatient care, potentially leading to premature discharges and higher readmission rates, says a new study in Medical Care.

FierceHealthcare noted that “Researchers, led by Greg Sacks, M.D., analyzed data for more than 112,000 patients at 217 hospitals across 39 states derived from Medicare claims, American Hospital Association annual surveys and a national surgery registry. They found wide variation in the number of patents individual hospitals refer to inpatient facilities, ranging from 3 to 40 percent.”

“{T]hey found higher readmission rates and longer stays at facilities that are more likely to refer patients to inpatient facilities. Providers that most often referred patients to inpatient care had a likelihood of 24.1 percent for readmissions, compared to 21.2 percent for those that referred them least often. They found no such association for referrals to home healthcare.’

“Sacks and his team also determined teaching hospitals were more likely than non-teaching hospitals to refer patients to home healthcare, and that use of inpatient facilities correlated with shorter average length of stay.”

“The research team theorized the phenomenon may be the result of healthcare reimbursement policies that provide incentives for earlier discharges, and that further study is needed to determine the appropriateness of post-acute care.”

Contact Info

(617) 230-4965

Wellesley, Mass