Arid
DOI10.1097/MLR.0b013e31817d69d3
Medicare Home Health Patients' Transitions Through Acute And Post-Acute Care Settings
Wolff, Jennifer L.1,2,3,4; Meadow, Ann3,4; Weiss, Carlos O.2; Boyd, Cynthia M.1,2; Leff, Bruce1,2
通讯作者Wolff, Jennifer L.
会议名称135th Annual Meeting of the American-Public-Health-Association
会议日期NOV 03-07, 2007
会议地点Washington, DC
英文摘要

Objectives: To describe Medicare beneficiaries' transitions through home health care within the context of other acute and post-acute services, and to examine agreement between administrative claims and Outcome and Assessment Information Set (OASIS) measures of health services use.


Data Sources: The 2004 Chronic Condition Data Warehouse, including the Medicare 5% standard analytic file and OASIS. Study participants were 66,5 10 Medicare beneficiaries with a home health start of care assessment between January 15, 2004 and July 15. 2004 who were discharged before December 1, 2004.


Results: Home health patients frequently incurred acute and post-acute services during the 14 days preceding admission and the 30 days after discharge, predominantly in acute hospitals. Substantial differences were observed in beneficiaries' health and functioning, across livin,, arrangements; patients living alone were less medically complex, less disabled, and received less assistance than those living with others. Agreement between OASIS and administrative claims was uniformly low with regard to inpatient hospital, inpatient rehabilitation, and skilled nursing facility use in the 14 days preceding the home health start of care. Agreement between OASIS and administrative claims was uneven for the period after discharge from home health care; it was determined to be near perfect for inpatient hospital (kappa = 0.85) but was lower for inpatient rehabilitation and hospice (kappa = 0.22 and 0.10. respectively).


Conclusions: Findings reinforce the potential merit of patient-specific rather than setting-specific measures of quality. but underscore practical challenges to constructing measures that span data sources and episodes of care.


英文关键词home health transitional care Medicare post-acute care
来源出版物MEDICAL CARE
ISSN0025-7079
出版年2008
卷号46
期号11
页码1188-1193
出版者LIPPINCOTT WILLIAMS & WILKINS
类型Article;Proceedings Paper
语种英语
国家USA
收录类别CPCI-S ; CPCI-SSH ; SCI-E ; SSCI
WOS记录号WOS:000260745900010
WOS关键词MINIMUM DATA SET ; PSYCHOMETRIC CHARACTERISTICS ; OUTCOMES ; VALIDITY ; QUALITY ; SERVICES ; TRIAL
WOS类目Health Care Sciences & Services ; Health Policy & Services ; Public, Environmental & Occupational Health
WOS研究方向Health Care Sciences & Services ; Public, Environmental & Occupational Health
资源类型会议论文
条目标识符http://119.78.100.177/qdio/handle/2XILL650/297240
作者单位1.Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD 21205 USA;
2.Johns Hopkins Univ, Johns Hopkins Sch Med, Baltimore, MD USA;
3.Ctr Medicare, Baltimore, MD USA;
4.Ctr Medicaid Serv, Baltimore, MD USA
推荐引用方式
GB/T 7714
Wolff, Jennifer L.,Meadow, Ann,Weiss, Carlos O.,et al. Medicare Home Health Patients' Transitions Through Acute And Post-Acute Care Settings[C]:LIPPINCOTT WILLIAMS & WILKINS,2008:1188-1193.
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