Lack of home health support linked to readmissions

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New research adds even more fuel to the fire, in which some providers argue they face unfair financial penalties for readmissions outside of their control, with social factors affecting patients returning to the hospital.

According to a new study in the October-December Advances in Nursing Science journal, elderly patients who lacked support in a home health setting after a hospital stay fared worse than those who had a solid support system for self-care.

Hong Tao, assistant professor at University of Wisconsin Milwaukee College of Nursing, and other researchers found that a "self-care deficit" in the elderly post-hospitalization population correlated to bouncing back to the hospital, according to yesterday's research announcement. Patients' living arrangements, such as whether they lived alone or had a family member as a primary informal caregiver, as well as the frequency of care and the type of care provided, were all related to readmissions.

Researchers also found that the patients' age, obesity, lower levels of cognitive functioning also were linked to the self-care deficit.

"Patients who received more care were more likely to have a better functional ability," study authors wrote.

Out of the more than 1,200 elderly home healthcare patients studied, about 21 percent were rehospitalized within 60 days of being released from the hospital to home care; most of those people were back in the hospital in less than 20 days.

With 1 in every 4 patients discharged from hospital to home health being rehospitalized, national readmissions stood at a steady 29 percent in 2008, compared to 28 percent in 2004, according to the study.

Researchers noted the takeaway for providers is to improve social environmental support for the patients but also improve help for the informal caregivers.

"Caregivers of these patients may benefit from additional resources to help them manage the tiring physical demands of their patients," they wrote. "… Those patients who received environmental support from their caregivers in the form of psychosocial support, facilitating access to medical care or serving as a financial and/or health agent, tended to benefit, function at a higher level and have less potential for rehospitalization."

For more information:
- see the research announcement
- check out the study

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