Journal
GERIATRIC NURSING
Volume 35, Issue 2, Pages S37-S44Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.gerinurse.2014.02.018
Keywords
Skilled home health; Frontloading; Hospital readmission
Categories
Funding
- University of Maryland
- John A. Hartford Foundation
- National Institute for Nursing Research, Individualized Care for At-Risk Older Adults [T32-NR009356]
- Sigma Theta Tau International/National Gerontological Nursing Association Research Grant
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Hospitalization among older adults receiving skilled home health services continues to be prevalent. Frontloading of skilled nursing visits, defined as providing 60% of the planned skilled nursing visits within the first two weeks of home health episode, is one way home health agencies have attempted to reduce the need for readmission among this chronically ill population. This was a retrospective observational study using data from five Medicare-owned, national assessment and claim databases from 2009. An independent randomized sample of 4500 Medicare-reimbursed home health beneficiaries was included in the analyses. Propensity score analysis was used to reduce known confounding among covariates prior to the application of logistic analysis. Although whether skilled nursing visits were frontloaded or not was not a significant predictor of 30-day hospital readmission (p = 0.977), additional research is needed to refine frontloading and determine the type of patients who are most likely to benefit from it. (C) 2014 Mosby, Inc. All rights reserved.
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