In the past few years, the conclusion of most experts seems unanimous that patients receiving home health care exhibit a lower tendency to go to emergency rooms and require hospitalization. This also reduces costs for the government, states, private insurers, and the patients themselves due to soaring hospitalization costs. New data digs a little further on the topic, citing that the length of the actual home health visits on a case by case basis, can actually influence the chances of hospitalization and re-hospitalization. A study revealed that home health and homecare visits with lengths of time spanning from one minute above recorded averages and up, may in fact be tied to lower hospital readmission rates on a national basis. The study’s findings are significant in that they suggest that the quality, length and quantity of what services are provided to patients during home health visits have a large impact on patient outcomes and economic bottom lines. In other words, one minute here and there dedicated to extra care, diagnosis, and services, can prevent hours and days of re-hospitalization and the costs that accompany it.
One of the leading professors who worked on the study (which was conducted at the Wharton School in the University of Pennsylvania) stated that the clear conclusion was, the shorter the homecare visits, the higher the likelihood of readmission. He also cautioned not to immediately jump to the conclusion that home health agencies should create mandatory minimums in the length and services provided during the average visit.
The study examined scores of data from home health care companies across many U.S states, nearly 100 different offices in over 1/3 of the country’s biggest homecare markets. The data was compiled over a time span of nearly 4 years beginning in 2012. While the raw numbers indicated that one extra minute spent during a visit, reduced the chances of patient readmission by a little under 10%, more research needs to be done in the area to account for outside factors that could skew those numbers one way or the other. Researchers went in anticipating the opposite, thinking that a longer visit would show more problems with patients, which would suggest their chances of having to go back to the hospital were higher. The going logic was that sicker patients would require more attention, hence longer visits, and subsequently inevitable hospital stays. The facts seem to suggest that the causality factors seem to run in reverse.
There are however, subtle nuances that lay between the relationships in length of visit to re-hospitalization that must be accounted for. In the sample data, the average home health care visit lasted close to 50 minutes, with each single episode of care made up of an average of 14 visits. Home care visits can be cut shortened for a variety of different reasons that have to do with the patient and the caregiver involved. In many examples involving home health aides, an aide can be running behind schedule based on workload, or the dynamic of a visit can be cut based on where it falls within their workday. This alone does not singularly cause hospital re-admissions to rise, but paired with some of the other aforementioned factors, the perfect storm can occur.
More emphasis should be placed by providers on examination of the overall work schedule of the agency with regard to patients and staff. With a national shortage of caregivers, particularly in home health aides, this can be difficult for the average agency. Despite the study’s findings, many agree that the decision to systematically extend home health visits by one minute probably would not have a large measurable impact that would immediately drop re-admission rates. There is growing consensus however that extending the length comprehensively of all visits affecting all measured episodes of care could have a consistent affect.
Since comparatively, patient re-admissions are already a rare event, many see no need to even dig much deeper. So long as the less than 10% number remains consistent, few agencies and institutions would want to implement any sweeping changes.
The largest take-away from the study will be examined by government policy makers, who may end up calling for additional funding and flexibility in home health care services being provided, subsequently allowing for more time, attention and resources for agencies and caregivers to dedicate to their patient care.
If it is universally agreed that the equation is, the more time spent with patients the lower the readmission rate, there is a vested interest for all parties in reducing re-hospitalization. At minimum, these findings may highlight how large of an influencing factor home health care is.
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