Journal article
Factors Associated with Timing of the Start-of-Care Nursing Visits in Home Health Care
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, v 22(11), pp 2358-+
Nov 2021
PMID: 33844990
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objectives: Home health care patients have critical needs requiring timely care following hospital discharge. Although Medicare requires timely start-of-care nursing visits, a significant portion of home health care patients wait longer than 2 days for the first visit. No previous studies investigated the pattern of start-of-care visits or factors associated with their timing. This study's purpose was to examine variation in timing of start-of-care visits and characterize patients with visits later than 2 days postdischarge. Design: Retrospective cohort study. Setting/participants: Patients admitted to a large, Northeastern US, urban home health care organization during 2019. The study included 48,497 home care episodes for 45,390 individual patients. Measurement: We calculated time to start of care from hospital discharge for 2 patient groups: those seen within 2 days vs those seen >2 days postdischarge. We examined patient factors, hospital discharge factors, and timing of start of care using multivariate logistic regression. Results: Of 48,497 episodes, 16,251 (33.5%) had a start-of-care nursing visit >2 days after discharge. Increased odds of this time frame were associated with being black or Hispanic and having solely Medicaid insurance. Odds were highest for patients discharged on Fridays, Saturdays, and Mondays. Factors associated with visits within 2 days included surgical wound presence, urinary catheter, pain, 5 or more medications, and intravenous or infusion therapies at home. Conclusions and Implications: Findings provide the first publication of clinical and demographic characteristics associated with home health care start-of-care timing and its variation. Further examination is needed, and adjustments to staff scheduling and improved information transfer are 2 suggested interventions to decrease variation. (c) 2021 AMDA -The Society for Post-Acute and Long-Term Care Medicine.
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Details
- Title
- Factors Associated with Timing of the Start-of-Care Nursing Visits in Home Health Care
- Publication Details
- JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, v 22(11), pp 2358-+
- Publisher
- ELSEVIER SCIENCE INC; NEW YORK
- Grant note
- This study was supported in part by the National Institute of Nursing Research (R01 NR018831), Improving Patient Prioritization During Hospital-Homecare Transition: A Mixed Methods Study of a Clinical Decision Support Tool. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.%
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000712462100026
- Scopus ID
- 2-s2.0-85104338793
- Other Identifier
- 991021860763404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Geriatrics & Gerontology