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Home care first admissions are different from re-admissions

Home Health Care Services Quarterly 1986年第2期7卷 29-40页

作者： McIntosh, Ian D. Department of community Health Sciences University of Calgary AL T4N 6K8 4920-51 Street Red Deer Canada

Most previous papers on home care client populations, by not distinguishing between first and subsequent admissions, may create the impression that the characteristics of these two groups of patients are similar. When analysing these two groups from this data set separately, however, they show differences demographically, in length of stay, and in use of some services. Although, in many instances, these differences are not large, they are statistically significant, thus implying that type of admission i.e., first or subsequent, should be used routinely as a descriptive or explanatory variable in any analysis. © 1986 by The Haworth Press, Inc. All rights reserved.

关键词：艾伯塔家庭医疗保健服务/利用病人入院病人再入院老年人女(雌)性人类男(雄)性

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Home health care utilization: A causal model

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Home Health Care Services Quarterly 1989年第4期9卷 125-140页

作者： Starrett, Richard A. Rogers, Daniel Walters, Gary California School of Professional Psychology Fresno CA United States Business Manager of Surgery Mercy Hospital Toledo United States Napa State Hospital Napa United States

The present study develops and tests a causal model of home health care utilization by the Lucas County elderly. Path analysis was employed to evaluate the model on an area probability sample of 400 Ohio elderly. The findings indicate that the predictors of home health care are more diverse than was expected with the need factor (need for care, use of health appliances, limits to daily activities), enabling factor (knowledge of resources) and predisposing (age) factors all contributing to the use process. © 1989 Taylor & Francis Group, LLC.

关键词：日常生活活动年龄因素社区卫生服务就业卫生服务需求/统计学和数值数据卫生服务研究/统计学和数值数据家庭医疗保健服务/利用模型统计学俄亥俄人口性别因素老年人女(雌)性人类男(雄)性

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Prospective payment: Systemic effects on the provision of community care for the elderly

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Home Health Care Services Quarterly 1986年第2期7卷 93-117页

作者： Sankar, Andrea Newcomer, Robert Wood, Juanita Universily of Michigan MI United States University of California CA United States New School for Social Research United States

The financial incentives of Medicare's Prospective Payment System are encouraging hospitals to discharge patients sooner and at a lower functional status. This discussion analyzes the possible impact of the subacute patient on the community system of care. Three broad areas of potential impact are examined: (1) the systemic changes in the community system of care stimulated by vertical integration and the influx of proprietaries into community service delivery;(2) structural changes which may be experienced by community service agencies in meeting the demands of increased volume and increased acuity;(3) the impact on the family and the informal system of care delivery as it responds to the increased demands of caring for the subacute patient. © 1986 by The Haworth Press, Inc. All rights reserved.

关键词：社区卫生服务/利用家庭医疗保健服务/利用住院 Medicare 预期支付系统美国老年人人类

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Marketing home health care services to the referring physician: A preliminary analysis

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Health Marketing Quarterly 1987年第3-4期4卷 47-60页

作者： Ponzurick, Ellison S. Ponzurick, Thomas G. Abercrombie, C.L. Mongolia General Hospital Mongolia West Virginia University United States Memphis State University United States

No abstract available for this article.

关键词：数据收集家庭医疗保健服务/利用卫生服务使用研究医师问卷调查转诊和会诊/发展趋势田纳西

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Differences in the scalability of formal and informal in-home care of urban elderly

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Home Health Care Services Quarterly 1994年第4期14卷 105-116页

作者： Diwan, Sadhna Department of Social Work at Georgia State University United States

Differences in the scalability of formal and informal in-home care to elderly are examined. A Guttman scale showed that exclusive use of informal in-home care was hierarchically scalable, but not when services were provided by any formal sources. There was some clustering of formal services, for example, a large number of those who received meals also used homemaker services. However, a large number of those who received nursing did not receive personal care. There was no overall pattern to the use of formal services. Implications of these findings as related to service planning and delivery are discussed. © 1994 Taylor & Francis Group, LLC.

关键词：数据收集卫生服务需求卫生服务研究/方法老年人保健服务/分类老年人保健服务/统计学和数值数据家庭医疗保健服务/分类家庭医疗保健服务/统计学和数值数据家庭医疗保健服务/利用家庭护理(非专业)/分类家庭护理(非专业)/统计学和数值数据家庭护理(非专业)/利用俄亥俄城市卫生老年人人类

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A typology of service patterns in end-stage aids care:relationships to the transprofessional model

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Home Health Care Services Quarterly 1998年第1期17卷 73-92页

作者： Huba, G.J. Brief, Diana E. Cherin, David A. Panter, A.T. Melchior, Lisa A. The Measurement Group United States Visiting Nurse Association of Burbank Health Research Center United States

Objective. To determine the relationship among 11 types of home health care services for patients with HIV/AIDS and to develop a terminal-care, service-usage profile of persons receiving such services. Services include the number of psychiatric nurse visits, MedicalSocial Work (MSW) visits, evaluation visits, physical therapy visits, occupational therapy visits, homemaker visits, home health aide visits, public health nurse visits, registered nurse (RN) visits, Licensed Vocational Nurse (LVN) visits, and Intravenous (IV) nurse visits. Data Sources and Study Setting. Data were collected on 549 AIDS patients admitted for medical/surgical home-care services to the Visiting Nurse Association of Los Angeles (VNA-LA). The service utilization data were collected from the VNA-LA’s computerized datasystem. Study Design. The relationship among the service types was evaluated with principal component analysis. A service-usage profile was developed for patients using cluster analysis. To control for the variability in the amount of time that patients were on service, the numberof days that patients were in the VNA-LA program and were actuallyreceiving services was included as a factor that yielded a variable reflecting the number of each type of service that a patient received perday. Principal Findings. Five components were found to best describe the relationships among the service-type variables. These were identified as being: the Number of Evaluation Visits, the Number of Intensive Nursing Visits, the Number of Physical Therapy Visits, theNumber of Psychosocial Visits, and the Number of Attendant *** were found to cluster into 1 of 5 groups based on the type ofservice utilization profile that they received. The variables that appeared to have the most influence on this profile were the number ofhome health aide visits per day that the patient received, the numberof RN visits that were made, the number of IV nurse visits that wereprovided, and the number of LVN v

关键词：获得性免疫缺陷综合征/治疗聚类分析社区保健护理/组织和管理综合保健/组织和管理人口统计学卫生服务研究家庭医疗保健服务/组织和管理家庭医疗保健服务/利用洛杉矶模型组织管理社会支持临终医护/组织和管理临终医护/利用女(雌)性人类男(雄)性

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Measuring utilization and impact of home care services: A systems model approach for cost-effectiveness

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Home Health Care Services Quarterly 1984年第2期5卷 5-24页

作者： Rie Day, Suzanne Egg Harbor NJ 08215 Route 4. Box 12 United States

The relevance of home care research to policy questions is discussed as framework for study on “effects" (precursors and sequelae) of home care. This study used a large, multi-service agency’s longitudinal (8-year) case records (N = 2436) to examine a system model for relationships among entry characteristics, utilization of services, and need for services upon discharge from home care. Deducing case-mix from utilization patterns, pay plan at entry was identified as best of the available predictors of both duration and intensity (using multivariate analysis). Duration and intensity, dual contributors to “total visits,” were found to vary inversely and were predicted by different entering pay plans. While 1/3 of all cases were discharged to informal or self care, that was the most prevalent exit status of the clients (49%) who entered directly from hospital care. The methods used in disaggregating and analyzing these retrospectively-coded case records suggest that home services research:. 1. distinguish type, intensity, and duration as components of “total visits" which combine to account for costs of care;. 2. find concomitants of functional level (such as pay plan) which are accessible for designating case mix for purpose of projecting service use;. *** effectiveness in terms relevant lo stated objectives of the long term care system, which need to acknowledge mortality and to separate service needs at entry from those at exit from the series of formal and informal providers on a continuum of care. © 1984 by The Haworth Press, Inc.

关键词：加利福尼亚费用效益分析卫生政策卫生服务研究家庭医疗保健服务/利用模型理论系统分析老年人人类

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Changes in Aged Populations Served by Home Health Agencies

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Journal of Aging and Health 1990年第3期2卷 373-394页

作者： Swan, James H. Estes, Carroll L. California State University Long Beach United States University of California San Francisco United States

This article examines changes in clients served by home health agencies, and how changes are related to recent health care trends and local market structure. Two types of explanatory factors are examined: organizational measures and market factors. A theoretical model of isomorphism is tested, considering the effects of privatization within the context of the growth of chains and multifacility systems. Findings show that (a) system members are more likely than nonmembers to show increases in clients of all ages;(b) for-profits that are not system members are more likely to have increases in total clientele and in clients age 65-74, whereas for-profits' changes in clientele age 85 or over depends on their system membership-increasing among nonmembers, decreasing among members;and (c) agencies in states with home health “certificate of need” (CON) are more likely to have increases in clients age 65-74 and 85 and over. The results for total clientele and those age 65-74 support an isomorphism hypothesis. © 1990, Sage Publications. All rights reserved.

关键词：卫生服务易得程度卫生服务需求家庭医疗保健服务/组织和管理家庭医疗保健服务/利用模型统计学组织改革所有权/统计学和数值数据私有化/统计学和数值数据美国老年人人类

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Home alone: Unmet need for formal support services among home health clients

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Home Health Care Services Quarterly 1998年第2期17卷 1-20页

作者： Thomas, Cindy Parks Payne, Susan M. C. Brandeis University Institute for Health Policy Heller Graduate School Waltham MA 02254-9110 United States Case Western Reserve University MetroHealth Medical Center Cleveland OH 44109 2300 Metro Health Drive-R236 United States

In order to remain in the home without family or other informal support, home health clients must have access to essential formal services such as nutritional support and homemaking chores to supplement medical and nursing care. In this study, we looked at client-related factors associated with the need for formal support services, and factors associated with whether those needs are adequately met. Data were collected from 2,013 home health clients in Massachusetts. According to the assessment of the skilled nurses treating them, 85 percent of the clients needed one or more support services;some or all needs were not adequately met in nearly half. Significant factors contributing to unmet need included: being non-white, having Medicaid as payer, being in a health maintenance organization, having AIDS, receiving maternal/child health services, and having an acute condition. This research suggests that even clients receiving skilled nursing care may. © 1998, Taylor & Francis Group, LLC. All rights reserved.

关键词：获得性免疫缺陷综合征/护理社区保健护理/统计学和数值数据数据收集卫生保健调查健康维护组织卫生服务需求/统计学和数值数据家庭医疗保健服务/统计学和数值数据家庭医疗保健服务/利用马萨诸塞 Medicaid 模型统计学营养支持美国人类

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A vna home health care program: Predicting Patients Who Refuse Services

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Evaluation & the Health Professions 1982年第2期5卷 200-209页

作者： Legge, Jerome S. University of Georgia United States

Many studies have been compiled which report patient characteristics and patterns in the utilization of health care services. Very little information is available on the characteristics of patients who refuse sers'ices in a particular program. This article emplov s a sample of 246 home health care patients to describe the characteristics of persons refusing services compared to a group “normall/v ” terminating service. The method employed is discriminant anal}sis. The results of the study are substantively consistent with the theoretical and empirical literature on health care utilization. Those refusing service were less likel/v to be insured and tended to have multiple admissions to the program. They Here less inclined to improve in functional status, despite a tendenc y toward a longer stay in the program. Curious/i', fewer nursing visits occurred for these patients, despite their longer stays. Itnplications of the studvfor program management are discussed. © 1982, SAGE Publications. All rights reserved.

关键词：方差分析社区保健护理佐治亚家庭医疗保健服务/利用病人依从人类

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