Advance Care Planning Protocols and Hospitalization Rates in Home Health Value-Based Purchasing

IF 0.8 Q4 NURSING

Home Health Care Management and Practice Pub Date : 2021-05-28 DOI:10.1177/10848223211021393

S. Bigger, L. Haddad, Sangeeta C. Ahluwalia, L. Glenn

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引用次数: 3

Abstract

Advance care planning is a conversation about personal values, future treatment choices, and designation of a surrogate decision-maker, that someone has in advance of a health crisis. Most existing studies on advance care planning have taken place outside of home health among populations with HIV/AIDS, cancer, dementia, and end stage renal disease. The U.S. home health population is living longer with chronic conditions such as pulmonary and cardiovascular illnesses, and hospitalization is a poor outcome. In 2016, Medicare implemented the Home Health Value-Based Purchasing Model, in which reimbursement rates for agencies in 9 regionally representative states were dependent on quantitative measures of quality performance. Part of the program was a process-level mandate requiring agencies to report on advance care planning. The aim of this study was to examine the relationship of home health advance care planning protocols with hospitalization rates. Descriptive and regression analyses were conducted on survey data of protocols and agency data of demographics and outcomes. Statistical significance was found in the positive correlation between advance care planning protocols and hospitalization. Recommendations are made for broadening the scope of evaluation of quality in home health to include goal-concordant care and transitions to appropriate services.

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基于价值的家庭健康采购中的预先护理计划方案和住院率

预先护理计划是一种关于个人价值观、未来治疗选择和指定替代决策者的对话，这是某人在健康危机之前所做的。大多数现有的关于预先护理计划的研究都是在艾滋病毒/艾滋病、癌症、痴呆症和终末期肾病患者的家庭健康之外进行的。美国家庭健康人群因肺部和心血管疾病等慢性疾病而寿命更长，住院治疗的结果不佳。2016年，联邦医疗保险实施了基于家庭健康价值的购买模式，其中9个具有地区代表性的州的机构的报销率取决于质量绩效的量化指标。该计划的一部分是流程层面的授权，要求各机构报告预先护理计划。本研究的目的是检验家庭健康预先护理计划方案与住院率的关系。对协议的调查数据以及机构的人口统计和结果数据进行了描述性和回归分析。预先护理计划方案与住院治疗呈正相关，具有统计学意义。建议扩大家庭健康质量评估的范围，包括目标一致的护理和向适当服务的过渡。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Home Health Care Management and Practice NURSING-

CiteScore

2.30

自引率

18.20%

发文量

期刊介绍： Home Health Care Management & Practice is a comprehensive resource for clinicians, case managers, and administrators providing home and community based health care. Articles address diverse issues, ranging from individual patient care and case management to the human resource management and organizational operations management and administration of organizations and agencies. Regular columns focus on research, legal issues, psychosocial perspectives, accreditation and licensing, compliance, management, and cultural diversity. Specific topics include treatment, care and therapeutic techniques, cultural competence, family caregivers, equipment management, human resources, home health center.