Pub Date : 2022-03-14DOI: 10.1177/10848223221085684
Halah Almulla, Dena S. Hassouneh
Aging populations and a rising disease burden have increased the need for palliative care (PC). Despite the growing demand for PC, only 14% of patients worldwide receive this service. Home-based PC is necessary because many people prefer to receive care and die at home. Nurses are well equipped to address diverse health care needs in the community and are critical to successful delivery of home-based PC. The purpose of this review is to synthesize and analyze literature relevant to home-based PC in Saudi Arabia with an emphasis on nursing. This purpose required us to examine literature in two areas: PC and home health care (HHC). We identified studies through database searches. We found 24 studies published between 2005 and 2021 that met quality and inclusion criteria. Although PC and HHC are associated with positive outcomes, lack of nurses’ knowledge and awareness of PC and the underdevelopment of HHC in Saudi Arabia have contributed to underuse of these services. Nurses are vital to the functioning of interdisciplinary teams and effective interfacing with patients, caregivers, and families. Education and training of nurses in Saudi Arabia is essential to promoting access to PC and HHC and the development of home-based PC in the kingdom.
{"title":"Home-Based Palliative Care and Home Health Care in Saudi Arabia: An Integrative Literature Review","authors":"Halah Almulla, Dena S. Hassouneh","doi":"10.1177/10848223221085684","DOIUrl":"https://doi.org/10.1177/10848223221085684","url":null,"abstract":"Aging populations and a rising disease burden have increased the need for palliative care (PC). Despite the growing demand for PC, only 14% of patients worldwide receive this service. Home-based PC is necessary because many people prefer to receive care and die at home. Nurses are well equipped to address diverse health care needs in the community and are critical to successful delivery of home-based PC. The purpose of this review is to synthesize and analyze literature relevant to home-based PC in Saudi Arabia with an emphasis on nursing. This purpose required us to examine literature in two areas: PC and home health care (HHC). We identified studies through database searches. We found 24 studies published between 2005 and 2021 that met quality and inclusion criteria. Although PC and HHC are associated with positive outcomes, lack of nurses’ knowledge and awareness of PC and the underdevelopment of HHC in Saudi Arabia have contributed to underuse of these services. Nurses are vital to the functioning of interdisciplinary teams and effective interfacing with patients, caregivers, and families. Education and training of nurses in Saudi Arabia is essential to promoting access to PC and HHC and the development of home-based PC in the kingdom.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"34 1","pages":"288 - 301"},"PeriodicalIF":1.1,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48540027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-10DOI: 10.1177/10848223221082661
Chutima Phuaksaman, Watit Niyomkarn, Prapasri Somboon, W. Boonjindasup, S. Hantragool, S. Sritippayawan
Long-term outcomes of pediatric patients with a tracheostomy in developing countries where professional home nurse is not accessible has rarely been reported. We, therefore, investigated the prevalence and associating factors of long-term outcomes in these children. Retrospective chart review was conducted in 85 tracheostomized children who were discharged to home during January 2012 to December 2020. Tracheostomy home care was provided by caregivers who completed the tracheostomy home care program. Prevalence of unplanned readmission with acute respiratory problems within 30 days after the first hospital discharge was 17.6%. Lower respiratory tract infection (LRTI) after hospital discharge was found in 72.9% (median frequency of 1.0 episode/case/year). Among 80 children who had surveillance airway endoscopy, 46.3% demonstrated late tracheostomy-related airway complications. Independent factor associated with late tracheostomy-related airway complications was a follow-up period longer than 1 year. Decannulation success was found in 21.2%. Most of them had tracheostomy for their upper airway anomalies. The mortality rate was 7%. Most of them died from their underlying diseases. In conclusion, pediatric tracheostomy home care undertaken by caregivers is feasible in developing countries where home nurse is not available. The prevalence of unplanned readmission with acute respiratory problems within 30 days after hospital discharge and late tracheostomy-related airway complications were comparable with those reported in developed countries. However, we still had a high prevalence of post-tracheostomy LRTI which was a challenging problem that needed to be investigated and resolved.
{"title":"Long-term Outcomes of Pediatric Tracheostomy Home Care in a Limited Resource Setting of Professional Home Nurse","authors":"Chutima Phuaksaman, Watit Niyomkarn, Prapasri Somboon, W. Boonjindasup, S. Hantragool, S. Sritippayawan","doi":"10.1177/10848223221082661","DOIUrl":"https://doi.org/10.1177/10848223221082661","url":null,"abstract":"Long-term outcomes of pediatric patients with a tracheostomy in developing countries where professional home nurse is not accessible has rarely been reported. We, therefore, investigated the prevalence and associating factors of long-term outcomes in these children. Retrospective chart review was conducted in 85 tracheostomized children who were discharged to home during January 2012 to December 2020. Tracheostomy home care was provided by caregivers who completed the tracheostomy home care program. Prevalence of unplanned readmission with acute respiratory problems within 30 days after the first hospital discharge was 17.6%. Lower respiratory tract infection (LRTI) after hospital discharge was found in 72.9% (median frequency of 1.0 episode/case/year). Among 80 children who had surveillance airway endoscopy, 46.3% demonstrated late tracheostomy-related airway complications. Independent factor associated with late tracheostomy-related airway complications was a follow-up period longer than 1 year. Decannulation success was found in 21.2%. Most of them had tracheostomy for their upper airway anomalies. The mortality rate was 7%. Most of them died from their underlying diseases. In conclusion, pediatric tracheostomy home care undertaken by caregivers is feasible in developing countries where home nurse is not available. The prevalence of unplanned readmission with acute respiratory problems within 30 days after hospital discharge and late tracheostomy-related airway complications were comparable with those reported in developed countries. However, we still had a high prevalence of post-tracheostomy LRTI which was a challenging problem that needed to be investigated and resolved.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"34 1","pages":"269 - 276"},"PeriodicalIF":1.1,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46044372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-10DOI: 10.1177/10848223221079630
Morris Hamilton, Mary Juergens, Qing Zheng, Elizabeth Campbell, M. Plotzke
The Bipartisan Budget Act (BBA) of 20181 created a temporary transitional payment (TTP) through Medicare Part B, which establishes fee-for-service (FFS) payment for eligible home infusion suppliers when they furnish home infusion therapy (HIT) service visits by skilled professionals in a beneficiary’s home on the day of HIT drug administration. Payment varies by 3 condition-specific payment categories. The Centers for Medicare & Medicaid Services (CMS) implemented the TTP on January 1, 2019. The TTP ended when the permanent HIT benefit began on January 1, 2021. To better understand how beneficiaries utilized this benefit during the TTP period, we examine trends in HIT services utilization between January 2019 and December 2020. Despite being new, the HIT benefit showed only a slight ramp-up phase, with a stable level of visits evolving over the remainder of 2019 and early 2020. Utilization decreased during the COVID-19 public health emergency, especially for infusion drugs related to heart failure and cancer. Additionally, relative to the geographic distribution of the Medicare FFS population, HIT service visit users are concentrated in the mid-Atlantic states. HIT service visit users are more likely to be young, white or black, and urban dwelling, compared to the general Medicare FFS beneficiaries.
{"title":"Home Infusion Therapy: Utilization Under the Medicare Part B Temporary Transitional Payment","authors":"Morris Hamilton, Mary Juergens, Qing Zheng, Elizabeth Campbell, M. Plotzke","doi":"10.1177/10848223221079630","DOIUrl":"https://doi.org/10.1177/10848223221079630","url":null,"abstract":"The Bipartisan Budget Act (BBA) of 20181 created a temporary transitional payment (TTP) through Medicare Part B, which establishes fee-for-service (FFS) payment for eligible home infusion suppliers when they furnish home infusion therapy (HIT) service visits by skilled professionals in a beneficiary’s home on the day of HIT drug administration. Payment varies by 3 condition-specific payment categories. The Centers for Medicare & Medicaid Services (CMS) implemented the TTP on January 1, 2019. The TTP ended when the permanent HIT benefit began on January 1, 2021. To better understand how beneficiaries utilized this benefit during the TTP period, we examine trends in HIT services utilization between January 2019 and December 2020. Despite being new, the HIT benefit showed only a slight ramp-up phase, with a stable level of visits evolving over the remainder of 2019 and early 2020. Utilization decreased during the COVID-19 public health emergency, especially for infusion drugs related to heart failure and cancer. Additionally, relative to the geographic distribution of the Medicare FFS population, HIT service visit users are concentrated in the mid-Atlantic states. HIT service visit users are more likely to be young, white or black, and urban dwelling, compared to the general Medicare FFS beneficiaries.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"34 1","pages":"214 - 220"},"PeriodicalIF":1.1,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47926615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-03DOI: 10.1177/10848223221082660
Sharon E. Bigger, L. Glenn
Advance care planning (ACP) is a conversation about values, future treatment choices, and designation of a surrogate decision-maker, held in advance of a health crisis. ACP protocols are established by home health agencies (HHAs) to support the staff in talking about patients’ future treatment choices, which can include opting against acute care use. In 2016, Medicare implemented an experimental incentive program called Home Health Value-Based Purchasing (HHVBP) in 9 regionally representative states. These agencies were required to compete on value, where reimbursement rates were tied to outcomes in a Total Performance Score (TPS). With home health’s aim of avoiding unplanned acute care use, in-patient hospitalization was weighted the heaviest as a poor outcome, followed by emergency department (ED) use. The purpose of this quasi-interventional study was to determine the relationship between advance care planning protocols and ED use among HHAs in the U. S. by the status of participation HHVBP intervention group. The Advance Care Planning Protocol (ACPP) score was measured by scoring survey questions. Our findings show (1) ACPP score intensity was higher in states that participated in the HHVBP program; (2) high measurement reliability for the ACPP scores; (3) no significant relationship between ACPP and ED use overall; but (4) the relationship between ACPP intensity and ED use was equal-and-opposite for the HHVBP and non-HHVBP groups. These findings suggest that the HHVBP intervention altered the influence of ACPP intensity on ED use. Recommendations are made for the HHVBP program regarding ACP’s role in goal-concordant care.
{"title":"Emergency Department Use and Advance Care Planning in Home Health Value-Based Purchasing","authors":"Sharon E. Bigger, L. Glenn","doi":"10.1177/10848223221082660","DOIUrl":"https://doi.org/10.1177/10848223221082660","url":null,"abstract":"Advance care planning (ACP) is a conversation about values, future treatment choices, and designation of a surrogate decision-maker, held in advance of a health crisis. ACP protocols are established by home health agencies (HHAs) to support the staff in talking about patients’ future treatment choices, which can include opting against acute care use. In 2016, Medicare implemented an experimental incentive program called Home Health Value-Based Purchasing (HHVBP) in 9 regionally representative states. These agencies were required to compete on value, where reimbursement rates were tied to outcomes in a Total Performance Score (TPS). With home health’s aim of avoiding unplanned acute care use, in-patient hospitalization was weighted the heaviest as a poor outcome, followed by emergency department (ED) use. The purpose of this quasi-interventional study was to determine the relationship between advance care planning protocols and ED use among HHAs in the U. S. by the status of participation HHVBP intervention group. The Advance Care Planning Protocol (ACPP) score was measured by scoring survey questions. Our findings show (1) ACPP score intensity was higher in states that participated in the HHVBP program; (2) high measurement reliability for the ACPP scores; (3) no significant relationship between ACPP and ED use overall; but (4) the relationship between ACPP intensity and ED use was equal-and-opposite for the HHVBP and non-HHVBP groups. These findings suggest that the HHVBP intervention altered the influence of ACPP intensity on ED use. Recommendations are made for the HHVBP program regarding ACP’s role in goal-concordant care.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"34 1","pages":"280 - 287"},"PeriodicalIF":1.1,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48416551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-08DOI: 10.1177/10848223221078581
J. Daniel, K. Little
To conduct a home-visit program for nursing students, to improve student confidence and comfort completing home visits in the underserved region of Southside, Virginia. The project was conducted in a rural community, where 24 nursing students and 1 family nurse practitioner made home visits once a week from September to December 2020. Students were evaluated on both their understanding of community health nursing and home-visit comfort levels via an anonymous pre- and post-home-visit assessment. Thirteen of the twenty-four students (54%) completed both the pre- and post-surveys. Results of the paired sample t-tests showed a significant increase in students’ comfort level from before the visit (3.0769) to after the visit (3.3077, p = .005). Students’ confidence levels also increased from before the visit (2.6923) to after the visit (3.3846, p = .006). Nursing educators are challenged to provide nursing students with the knowledge and skills needed to provide competent and compassionate evidence-based care in the field. Nursing student reported confidence in their nursing skills in the field after completing the home visit. Future research is needed on the benefit of completing home visits in nursing education programs.
{"title":"Meeting the Needs of a Rural Community: A BSN Home-Visit Program Integrating Classroom and Clinical Skills","authors":"J. Daniel, K. Little","doi":"10.1177/10848223221078581","DOIUrl":"https://doi.org/10.1177/10848223221078581","url":null,"abstract":"To conduct a home-visit program for nursing students, to improve student confidence and comfort completing home visits in the underserved region of Southside, Virginia. The project was conducted in a rural community, where 24 nursing students and 1 family nurse practitioner made home visits once a week from September to December 2020. Students were evaluated on both their understanding of community health nursing and home-visit comfort levels via an anonymous pre- and post-home-visit assessment. Thirteen of the twenty-four students (54%) completed both the pre- and post-surveys. Results of the paired sample t-tests showed a significant increase in students’ comfort level from before the visit (3.0769) to after the visit (3.3077, p = .005). Students’ confidence levels also increased from before the visit (2.6923) to after the visit (3.3846, p = .006). Nursing educators are challenged to provide nursing students with the knowledge and skills needed to provide competent and compassionate evidence-based care in the field. Nursing student reported confidence in their nursing skills in the field after completing the home visit. Future research is needed on the benefit of completing home visits in nursing education programs.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"34 1","pages":"277 - 279"},"PeriodicalIF":1.1,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42756722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-03DOI: 10.1177/10848223221075052
N. Howard, Darrin A. Adams, Jena Cole
Home-based health care can be physically and emotionally demanding, resulting in injury or illness. Washington State’s workers’ compensation compensable claims between 2006 and 2016 were analyzed to describe the characteristics of injured home-based health care (HBHC) providers and the burden created by these injuries. Comparisons were made with clinical health care (CHC) providers, as well as between all compensable claims and work-related musculoskeletal disorder (WMSD) claims. Over 90% of claimants for both HBHC and CHC were female. The mean age of all compensable HBHC claimants (45.7 years) was significantly older than for CHC, with the majority (54.5%) between the ages of 40 and 59. However, HBHC claimants with WMSDs were younger, overall. Across health care type and claim type, the majority of injured care providers were overweight or obese (BMI ≥ 25). The highest mean age occurred among claimants injured from falls, either on the same level or to a lower level (HBHC: 48.3-48.6 years, CHC: 46.1-48.1 years). This same group also had the highest BMIs. WMSDs accounted for 47.3% of HBHC compensable claims and 50.3% for CHC. Falls on the same level were the second most common injury event among HBHC claims. For both HBHC and CHC, back injuries were the most common body part for both claim types (all compensable claims: 28.8% HBHC and 23.9% CHC, WMSD claims: 60.8% HBHC and 47.5% CHC). Overexertion was the injury event most attributed to WMSDs (HBHC: 82.6%, CHC: 71.6), overexertion during lifting being the most prevalent overexertion type (HBHC: 27.8%, CHC: 19.6%).
{"title":"An Examination of Washington State Workers’ Compensation Claims for Home-Based Health Care Workers, 2006 to 2016: Part 1. Description of Claims and Claimants","authors":"N. Howard, Darrin A. Adams, Jena Cole","doi":"10.1177/10848223221075052","DOIUrl":"https://doi.org/10.1177/10848223221075052","url":null,"abstract":"Home-based health care can be physically and emotionally demanding, resulting in injury or illness. Washington State’s workers’ compensation compensable claims between 2006 and 2016 were analyzed to describe the characteristics of injured home-based health care (HBHC) providers and the burden created by these injuries. Comparisons were made with clinical health care (CHC) providers, as well as between all compensable claims and work-related musculoskeletal disorder (WMSD) claims. Over 90% of claimants for both HBHC and CHC were female. The mean age of all compensable HBHC claimants (45.7 years) was significantly older than for CHC, with the majority (54.5%) between the ages of 40 and 59. However, HBHC claimants with WMSDs were younger, overall. Across health care type and claim type, the majority of injured care providers were overweight or obese (BMI ≥ 25). The highest mean age occurred among claimants injured from falls, either on the same level or to a lower level (HBHC: 48.3-48.6 years, CHC: 46.1-48.1 years). This same group also had the highest BMIs. WMSDs accounted for 47.3% of HBHC compensable claims and 50.3% for CHC. Falls on the same level were the second most common injury event among HBHC claims. For both HBHC and CHC, back injuries were the most common body part for both claim types (all compensable claims: 28.8% HBHC and 23.9% CHC, WMSD claims: 60.8% HBHC and 47.5% CHC). Overexertion was the injury event most attributed to WMSDs (HBHC: 82.6%, CHC: 71.6), overexertion during lifting being the most prevalent overexertion type (HBHC: 27.8%, CHC: 19.6%).","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"34 1","pages":"191 - 201"},"PeriodicalIF":1.1,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65854976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-03DOI: 10.1177/10848223221076491
N. Howard, Darrin A. Adams, Jennifer Marcum, Jena Cole
Research of home-based health care (HBHC) has shown that care providers suffer from a high rate of injuries. Analysis of workers’ compensation records, a reliable source for injury and illness data, enables the identification of trends within a specific working population. HBHC workers’ compensation compensable claims in Washington State from 2006 to 2016 were compared to clinical health care (CHC) claims. Injury event and source attributed to HBHC claims were also analyzed, with a focus on work-related musculoskeletal disorders (WMSDs). Though CHC had 5 times the number of full-time employees during the study period, HBHC grew by 61.1%, compared to 28.7% in CHC. Claim rates for all compensable claims and WMSD claims consistently decreased year-over-year for both HBHC and CHC. WMSD claims experienced a year-over-year decline of 5.3%; for all compensable claims the decline was 4.5%. Analysis of HBHC claim rates by injury event found WMSD had the highest rates, followed by falls from the same level. However, the largest annual change was for the injury event overexertion (−10.1%, 95%CI: −13.4, −6.8). HBHC injuries attributable to the health care patient were the most common. Claims with this injury source declined annually by 6.0%. Claim rates for injuries to the back region, and specifically back WMSDs, were consistently higher year-over-year compared to other body regions and WMSD types. Claims for injuries to the back declined by an annual rate of 6.6% (95% CI: −7.9, −5.3), while back WMSD claims decreased by 6.4% (94% CI: −7.8, −4.9).
{"title":"An Examination of Washington State Workers’ Compensation Claims for Home-Based Health Care Workers, 2006 to 2016: Part 2. Injury Rates and Trends","authors":"N. Howard, Darrin A. Adams, Jennifer Marcum, Jena Cole","doi":"10.1177/10848223221076491","DOIUrl":"https://doi.org/10.1177/10848223221076491","url":null,"abstract":"Research of home-based health care (HBHC) has shown that care providers suffer from a high rate of injuries. Analysis of workers’ compensation records, a reliable source for injury and illness data, enables the identification of trends within a specific working population. HBHC workers’ compensation compensable claims in Washington State from 2006 to 2016 were compared to clinical health care (CHC) claims. Injury event and source attributed to HBHC claims were also analyzed, with a focus on work-related musculoskeletal disorders (WMSDs). Though CHC had 5 times the number of full-time employees during the study period, HBHC grew by 61.1%, compared to 28.7% in CHC. Claim rates for all compensable claims and WMSD claims consistently decreased year-over-year for both HBHC and CHC. WMSD claims experienced a year-over-year decline of 5.3%; for all compensable claims the decline was 4.5%. Analysis of HBHC claim rates by injury event found WMSD had the highest rates, followed by falls from the same level. However, the largest annual change was for the injury event overexertion (−10.1%, 95%CI: −13.4, −6.8). HBHC injuries attributable to the health care patient were the most common. Claims with this injury source declined annually by 6.0%. Claim rates for injuries to the back region, and specifically back WMSDs, were consistently higher year-over-year compared to other body regions and WMSD types. Claims for injuries to the back declined by an annual rate of 6.6% (95% CI: −7.9, −5.3), while back WMSD claims decreased by 6.4% (94% CI: −7.8, −4.9).","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"34 1","pages":"202 - 213"},"PeriodicalIF":1.1,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47856999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-21DOI: 10.1177/10848223211073710
R. García-Carretero, Óscar Vázquez-Gómez, Esther Luna-Heredia, Borja Vargas-Rojo, M. Fernández-Cotarelo, Gema Naranjo-Mansilla
We performed exploratory and descriptive analyses of data from our 8 years of experience in hospital-at-home (HaH) treatment to characterize the clinical profile of patients with exacerbated underlying chronic obstructive pulmonary disease (COPD). Our study had a retrospective research design, using historical electronic health records from patients admitted to the HaH setting between 2012 and 2019. We collected demographic, administrative, and clinical data from patients diagnosed with exacerbated COPD. Between 2012 and 2019, 420 patients diagnosed with acute respiratory infectious disease related to COPD were treated in our HaH setting (18% of all admissions to HaH). Most patients were referred from the Internal Medicine Department. The median length of the hospital stay was 10 days. Most patients (78.8%) presented acute exacerbation with no pneumonia. One-third of the patients required domiciliary oxygen therapy, and half required ventilatory devices for nebulized bronchodilator therapy. All patients were successfully discharged as clinically stable. Our HaH experience in managing patients with exacerbated COPD indicates a means of obtaining cost savings and increased quality of life for patients in which antibiotic and ventilatory therapy is not compromised.
{"title":"Management of COPD in a Hospital-at-Home Setting at a Peripheral Spanish Hospital: 8-Year Experience","authors":"R. García-Carretero, Óscar Vázquez-Gómez, Esther Luna-Heredia, Borja Vargas-Rojo, M. Fernández-Cotarelo, Gema Naranjo-Mansilla","doi":"10.1177/10848223211073710","DOIUrl":"https://doi.org/10.1177/10848223211073710","url":null,"abstract":"We performed exploratory and descriptive analyses of data from our 8 years of experience in hospital-at-home (HaH) treatment to characterize the clinical profile of patients with exacerbated underlying chronic obstructive pulmonary disease (COPD). Our study had a retrospective research design, using historical electronic health records from patients admitted to the HaH setting between 2012 and 2019. We collected demographic, administrative, and clinical data from patients diagnosed with exacerbated COPD. Between 2012 and 2019, 420 patients diagnosed with acute respiratory infectious disease related to COPD were treated in our HaH setting (18% of all admissions to HaH). Most patients were referred from the Internal Medicine Department. The median length of the hospital stay was 10 days. Most patients (78.8%) presented acute exacerbation with no pneumonia. One-third of the patients required domiciliary oxygen therapy, and half required ventilatory devices for nebulized bronchodilator therapy. All patients were successfully discharged as clinically stable. Our HaH experience in managing patients with exacerbated COPD indicates a means of obtaining cost savings and increased quality of life for patients in which antibiotic and ventilatory therapy is not compromised.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"34 1","pages":"246 - 251"},"PeriodicalIF":1.1,"publicationDate":"2022-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48893877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-21DOI: 10.1177/10848223211073900
Beth A. Longo, S. Schmaltz, Scott C. Williams
This was a descriptive replication study comparing 2083 home health agencies accredited by The Joint Commission (TJC) and 8695 non-TJC-accredited home health agencies over a 3-year period using the Centers for Medicare and Medicaid Services Home Health Compare data set. Metrics included the star ratings and 17 quality measures. A longitudinal model was used to determine differences between TJC-accredited and non-TJC-accredited organizations on the quality measures. Categorical differences in star ratings were analyzed using a Cochran-Mantel-Haenszel test. TJC-accredited home health agencies had better average ratings than non-TJC-accredited home health agencies for each of the 3 years (3.4 vs 3.2, p < .001). When categories were collapsed to evaluate differences, the analysis revealed that a significantly larger proportion of TJC-accredited facilities were clustered within the higher ratings (41% for TJC-accredited vs 32% for non-TJC-accredited), and fewer TJC-accredited organizations were clustered within the lower ratings (22% for TJC-accredited vs 30% for non-TJC-accredited; p < .001). Two claims-based outcome measures (hospitalization and emergency room visits) were consistent with the original study in which TJC-accredited home health organizations had statistically significant lower rates across all 3 years studied, compared to non-TJC-accredited HHAs. This replication study validates and extends the generalizability of the findings from the original study.
{"title":"Comparing Public Quality Ratings for Joint Commission Accredited and Non-Joint Commission Accredited Home Health Agencies: A Replication Study","authors":"Beth A. Longo, S. Schmaltz, Scott C. Williams","doi":"10.1177/10848223211073900","DOIUrl":"https://doi.org/10.1177/10848223211073900","url":null,"abstract":"This was a descriptive replication study comparing 2083 home health agencies accredited by The Joint Commission (TJC) and 8695 non-TJC-accredited home health agencies over a 3-year period using the Centers for Medicare and Medicaid Services Home Health Compare data set. Metrics included the star ratings and 17 quality measures. A longitudinal model was used to determine differences between TJC-accredited and non-TJC-accredited organizations on the quality measures. Categorical differences in star ratings were analyzed using a Cochran-Mantel-Haenszel test. TJC-accredited home health agencies had better average ratings than non-TJC-accredited home health agencies for each of the 3 years (3.4 vs 3.2, p < .001). When categories were collapsed to evaluate differences, the analysis revealed that a significantly larger proportion of TJC-accredited facilities were clustered within the higher ratings (41% for TJC-accredited vs 32% for non-TJC-accredited), and fewer TJC-accredited organizations were clustered within the lower ratings (22% for TJC-accredited vs 30% for non-TJC-accredited; p < .001). Two claims-based outcome measures (hospitalization and emergency room visits) were consistent with the original study in which TJC-accredited home health organizations had statistically significant lower rates across all 3 years studied, compared to non-TJC-accredited HHAs. This replication study validates and extends the generalizability of the findings from the original study.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"34 1","pages":"239 - 245"},"PeriodicalIF":1.1,"publicationDate":"2022-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48111188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-21DOI: 10.1177/10848223211073896
Ayşe Gök
The primary purpose of this research is to examine the experiences of individuals diagnosed with COVID-19 regarding the quarantine process. This research was carried out in a phenomenological design, one of the qualitative research approaches. A total of 212 volunteers, 153 women (72.2%) and 59 men (27.8), took part in this research via an online questionnaire. As a data collection tool, an online questionnaire prepared by the researcher was used. The data were analyzed within the framework of content analysis. In the findings of the research, 4 themes named as being diagnosed with COVID-19, quarantine process, worst-case scenario and coping with uncertainty were got. Based on the research findings, in staying in quarantine at home, besides the physiological effects of the virus, it can be concluded that individuals are trying to struggle with the emotional burden of the situation they are in. For this reason, it is of great importance to provide mental health support to individuals who are in quarantine at home, considering the social, psychological, and economic effects of the COVID-19 pandemic.
{"title":"Examination of Home Quarantine Experiences of Individuals Diagnosed With COVID-19 Living in Turkey","authors":"Ayşe Gök","doi":"10.1177/10848223211073896","DOIUrl":"https://doi.org/10.1177/10848223211073896","url":null,"abstract":"The primary purpose of this research is to examine the experiences of individuals diagnosed with COVID-19 regarding the quarantine process. This research was carried out in a phenomenological design, one of the qualitative research approaches. A total of 212 volunteers, 153 women (72.2%) and 59 men (27.8), took part in this research via an online questionnaire. As a data collection tool, an online questionnaire prepared by the researcher was used. The data were analyzed within the framework of content analysis. In the findings of the research, 4 themes named as being diagnosed with COVID-19, quarantine process, worst-case scenario and coping with uncertainty were got. Based on the research findings, in staying in quarantine at home, besides the physiological effects of the virus, it can be concluded that individuals are trying to struggle with the emotional burden of the situation they are in. For this reason, it is of great importance to provide mental health support to individuals who are in quarantine at home, considering the social, psychological, and economic effects of the COVID-19 pandemic.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"34 1","pages":"229 - 236"},"PeriodicalIF":1.1,"publicationDate":"2022-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47927784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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