OHCS
Maximizing the Cost Effectiveness of Home Health Care: The Influence of Service Volume and Integration
with Other Care Settings on Patient Outcome
(Outcomes of Home Care Study)
Funded by: Health Care Financing Administration
Project Period: 1994 - 2000
The main study objective was to assess empirically the relationships between
home health care volume and patient outcomes for Medicare beneficiaries age
65 and over. Volume was defined as home health visits per patient over a
specific interval, such as year, case, or episode. To partially control for
the wide variation in home health case mix, the study design focused on four
specific conditions that represent a range of patient circumstances for which
home health care is received: congestive heart failure, stroke, surgical hip
procedures, and wounds. Data for 1996-1998 were obtained from approximately 90
home health agencies stratified into state volume categories (i.e., high-,
moderate, and low-visits per episode, approximated by home health visits per
Medicare beneficiary receiving home health care in calendar year 1994).
Primary data were analyzed on 4014 episodes at 60-day intervals from start of
home health care until discharge, hospitalization, or the end of the study data
collection period. Medicare claims data were obtained for utilization and cost
analyses. The study found positive but varied relationships between home
health volume per episode and outcomes. The strongest results pertained to
functional improvement outcomes for the more post-acute conditions of surgical
hip procedures and wounds.
Key Staff: Schlenker, Powell, Engle, Shaughnessy
Research Monographs:
Schlenker RE, Powell MC, Goodrich GK,Stearns P, Brown L, DeVore PA. Interim Report on Home Health Volume and Case Mix Comparisons, Study Paper 2, February 1999.
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