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10.1001/jamanetworkopen.2020.15470 http://scihub22266oqcxt.onion/10.1001/jamanetworkopen.2020.15470 32876682!7489821!32876682     free     free     free Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       JAMA+Netw+Open 2020 ; 3 (9): e2015470 Nephropedia Template TP {{tp|p=32876682|t=2020. Assessment of Receipt of the First Home Health Care Visit After Hospital Discharge Among Older Adults |pdf=|usr=}}{{32876682}} gab.com Text Assessment of Receipt of the First Home Health Care Visit After Hospital Discharge Among Older Adults JO: JAMA Netw Open http://www.kidney.de/pget.php?&tw=1&pmid=32876682 #FOAvip IMPORTANCE: Home health care is one of the fastest growing postacute services in the US and is increasingly important in the era of coronavirus disease 2019 and payment reform, yet it is unknown whether patients who need home health care are receiving it. OBJECTIVE: To examine how often patients referred to home health care at hospital discharge receive it and whether there is evidence of disparities. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used Medicare data regarding the postacute home health care setting from October 1, 2015, through September 30, 2016. The participants were Medicare fee-for-service and Medicare Advantage beneficiaries who were discharged alive from a hospital with a referral to home health care (2?379?506 discharges). Statistical analysis was performed from July 2019 to June 2020. EXPOSURES: Hospital referral to home health care. MAIN OUTCOMES AND MEASURES: Primary outcomes included whether discharges received their first home health care visit within 14 days of hospital discharge and the number of days between hospital discharge and the first home health visit. Differences in the likelihood of receiving home health care across patient, zip code, and hospital characteristics were also examined. RESULTS: Among 2?379?506 discharges from the hospital with a home health care referral, 1?358?697 patients (57.1%) were female, 468?762 (19.7%) were non-White, and 466?383 (19.6%) were dually enrolled in Medicare and Medicaid; patients had a mean (SD) age of 73.9 (11.9) years and 4.1 (2.1) Elixhauser comorbidities. Only 1?284?300 patients (54.0%) discharged from the hospital with a home health referral received home health care services within 14 days of discharge. Of the remaining 1?095?206 patients (46.0%) discharged, 37.7% (896?660 discharges) never received any home health care, while 8.3% (198?546 discharges) were institutionalized or died within 14 days without a preceding home health care visit. Patients who were Black or Hispanic received home health at lower rates than did patients who were White (48.0% [95% CI, 47.8%-48.1%] of Black and 46.1% [95% CI, 45.7%-46.5%] of Hispanic discharges received home health within 14 days compared with 55.3% [95% CI, 55.2%-55.4%] of White discharges). In addition, disadvantaged patients waited longer for their first home health care visit. For example, patients living in high-unemployment zip codes waited a mean of 2.0 days (95% CI, 2.0-2.0 days), whereas those living in low-unemployment zip codes waited 1.8 days (95% CI, 1.8-1.8 days). CONCLUSIONS AND RELEVANCE: Disparities in the use of home health care remain an issue in the US. As home health care is increasingly presented as a safer alternative to institutional postacute care during coronavirus disease 2019, and payment reforms continue to pressure hospitals to discharge patients home, ensuring the availability of safe and equitable care will be crucial to maintaining high-quality care. Twit Text FOAVip Assessment of Receipt of the First Home Health Care Visit After Hospital Discharge Among Older Adults ????JAMA Netw Open http://www.kidney.de/pget.php?&tw=1&pmid=32876682 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=32876682 #FOAvip English Wikipedia <ref>{{Cite pmid|32876682}}</ref> Assessment of Receipt of the First Home Health Care Visit After Hospital Discharge Among Older Adults #MMPMID32876682 Li J; Qi M; Werner RM JAMA Netw Open 2020[Sep]; 3 (9): e2015470 PMID32876682show ga IMPORTANCE: Home health care is one of the fastest growing postacute services in the US and is increasingly important in the era of coronavirus disease 2019 and payment reform, yet it is unknown whether patients who need home health care are receiving it. OBJECTIVE: To examine how often patients referred to home health care at hospital discharge receive it and whether there is evidence of disparities. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used Medicare data regarding the postacute home health care setting from October 1, 2015, through September 30, 2016. The participants were Medicare fee-for-service and Medicare Advantage beneficiaries who were discharged alive from a hospital with a referral to home health care (2?379?506 discharges). Statistical analysis was performed from July 2019 to June 2020. EXPOSURES: Hospital referral to home health care. MAIN OUTCOMES AND MEASURES: Primary outcomes included whether discharges received their first home health care visit within 14 days of hospital discharge and the number of days between hospital discharge and the first home health visit. Differences in the likelihood of receiving home health care across patient, zip code, and hospital characteristics were also examined. RESULTS: Among 2?379?506 discharges from the hospital with a home health care referral, 1?358?697 patients (57.1%) were female, 468?762 (19.7%) were non-White, and 466?383 (19.6%) were dually enrolled in Medicare and Medicaid; patients had a mean (SD) age of 73.9 (11.9) years and 4.1 (2.1) Elixhauser comorbidities. Only 1?284?300 patients (54.0%) discharged from the hospital with a home health referral received home health care services within 14 days of discharge. Of the remaining 1?095?206 patients (46.0%) discharged, 37.7% (896?660 discharges) never received any home health care, while 8.3% (198?546 discharges) were institutionalized or died within 14 days without a preceding home health care visit. Patients who were Black or Hispanic received home health at lower rates than did patients who were White (48.0% [95% CI, 47.8%-48.1%] of Black and 46.1% [95% CI, 45.7%-46.5%] of Hispanic discharges received home health within 14 days compared with 55.3% [95% CI, 55.2%-55.4%] of White discharges). In addition, disadvantaged patients waited longer for their first home health care visit. For example, patients living in high-unemployment zip codes waited a mean of 2.0 days (95% CI, 2.0-2.0 days), whereas those living in low-unemployment zip codes waited 1.8 days (95% CI, 1.8-1.8 days). CONCLUSIONS AND RELEVANCE: Disparities in the use of home health care remain an issue in the US. As home health care is increasingly presented as a safer alternative to institutional postacute care during coronavirus disease 2019, and payment reforms continue to pressure hospitals to discharge patients home, ensuring the availability of safe and equitable care will be crucial to maintaining high-quality care. |*Health Services Accessibility[MESH] |*Referral and Consultation[MESH] |Aftercare/*statistics & numerical data[MESH] |Aged[MESH] |Aged, 80 and over[MESH] |Black or African American/statistics & numerical data[MESH] |Cross-Sectional Studies[MESH] |Fee-for-Service Plans[MESH] |Female[MESH] |Healthcare Disparities/*ethnology/statistics & numerical data[MESH] |Hispanic or Latino/statistics & numerical data[MESH] |Home Care Services/*statistics & numerical data[MESH] |Humans[MESH] |Male[MESH] |Medicaid/statistics & numerical data[MESH] |Medicare[MESH] |Medicare Part C[MESH] |Patient Discharge[MESH] |Poverty/statistics & numerical data[MESH] |Residence Characteristics/statistics & numerical data[MESH] |Unemployment/statistics & numerical data[MESH] |United States[MESH]Assessment of Receipt of the First Home Health Care Visit After Hospit(epmc).pdf DeepDyve Pubget Overpricing