Effectiveness of Home Health Care in Reducing Return to Hospital: Evidence from a Multi-hospital Study in the US

Authors

Danielle M. Siclovan, Froedtert HospitalFollow
James Bang, St Ambrose University
Olga Yakusheva, University of MichiganFollow
Morris Hamilton, Abt AssociatesFollow
Kathleen L. Bobay, Loyola University Chicago
Linda L. Costa, University of Maryland - BaltimoreFollow
Ronda G. Hughes, University of South CarolinaFollow
Jane M. Miles, Marquette UniversityFollow
Sarah J. Bahr, Marquette University
Marianne Weiss, Marquette UniversityFollow

Document Type

Article

Publication Date

7-2021

Publisher

Elsevier

Source Publication

International Journal of Nursing Studies

Source ISSN

0020-7489

Abstract

Background

Home health care, a commonly used bridge strategy for transitioning from hospital to home-based care, is expected to contribute to readmission avoidance efforts. However, in studies using disease-specific samples, evidence about the effectiveness of home health care in reducing readmissions is mixed.

Objective

To examine the effectiveness of home health care in reducing return to hospital across a diverse sample of patients discharged home following acute care hospitalization.

Research design

Secondary analysis of a multi-site dataset from a study of discharge readiness assessment and post-discharge return to hospital, comparing matched samples of patients referred and not referred for home health care at the time of hospital discharge.

Setting

Acute care, Magnet-designated hospitals in the United States

Participants

The available sample (n = 18,555) included hospitalized patients discharged from medical-surgical units who were referred (n = 3,579) and not referred (n = 14,976) to home health care. The matched sample included 2767 pairs of home health care and non- home health care patients matched on patient and hospitalization characteristics using exact and Mahalanobis distance matching.

Methods

Unadjusted t-tests and adjusted multinomial logit regression analyses to compare the occurrence of readmissions and Emergency Department/Observation visits within 30 and 60-days post-discharge.

Results

No statistically significant differences in readmissions or Emergency Department /Observation visits between home health care and non-home health care patients were observed.

Conclusions

Home health care referral was not associated with lower rates of return to hospital within 30 and 60 days in this US sample matched on patient and clinical condition characteristics. This result raises the question of why home health care services did not produce evidence of lower post-discharge return to hospital rates. Focused attention by home health care programs on strategies to reduce readmissions is needed.

Comments

Accepted version. International Journal of Nursing Studies, Vol. 119 (July 2021): 103946. DOI. © 2021 Elsevier. Used with permission.

Recommended Citation

Siclovan, Danielle M.; Bang, James; Yakusheva, Olga; Hamilton, Morris; Bobay, Kathleen L.; Costa, Linda L.; Hughes, Ronda G.; Miles, Jane M.; Bahr, Sarah J.; and Weiss, Marianne, "Effectiveness of Home Health Care in Reducing Return to Hospital: Evidence from a Multi-hospital Study in the US" (2021). College of Nursing Faculty Research and Publications. 897.
https://epublications.marquette.edu/nursing_fac/897