Which of the following statements best describes the most essential difference between home health care and acute client care? a. Home health care is a wide range of health care services that you can receive at home in the event of an illness or injury.
Home health care
is often less expensive, more convenient, and as effective as care received in a hospital or skilled nursing facility (SNF). Home health care includes a wide range of health care services that can be provided in your home.It is often used to help people recover from surgery, injury, or acute illness. Home health care providers, such as Amedisys, also help people manage chronic diseases such as diabetes, COPD or heart disease at home. Home health care consists of specialized and medically necessary services prescribed by a doctor for the treatment of an illness, injury, or medical condition. Home health care is a system of care that qualified professionals provide to patients in their homes under the direction of a physician.
Home health care services include nursing care; physical, occupational, and speech-language therapy; and medical social services.1 The goals of home health care services are to help people improve their functioning and live more independently; to promote the client's optimal level of well-being; and to help the patient stay at home, avoiding hospitalization or admission to long-term care institutions. From 2 to 4 doctors can refer patients to home health care services, or family members can request patient services. The Centers for Medicare and Medicaid Services (CMS) estimates that 8,090 home health agencies in the United States provide care for more than 2.4 million elderly and disabled people a year5. In order to receive reimbursement from Medicare, a doctor must consider that home health care services are medically necessary by a doctor and are provided to a homebound patient. In addition, care must be provided intermittently and discontinuously, 5 Medicare beneficiaries who are in poor health, low incomes, and 85 years or older have relatively high rates of home health care use, 6 common diagnoses among home health care patients include circulatory diseases (31 percent of patients), heart disease (16 percent), injuries and poisoning (15.9 percent), musculoskeletal and connective tissue diseases (14.1 percent), and respiratory diseases ( 11.6 percent).
Professional doctors have no authority over these caregivers. In addition, the family environment and the intermittent nature of professional home health care services can limit a doctor's ability to observe the quality of care provided by informal caregivers, unlike what happens in the hospital, where the care provided by support staff can be more easily observed and evaluated. For example, because of limited access to transportation, a husband may decide not to buy diabetes supplies for his dependent wife. The doctor may not pay attention to this behavior until an adverse event has occurred. Evidence-based interventions are based on careful evaluation. However, the limited opportunity to observe the patient and informal caregivers directly can hamper efforts to quickly determine the etiology of an adverse event.
If a patient receiving home health care has bruises that the patient can't explain, is the cause a fall, physical abuse, or blood dyscrasia? Both with regard to self-care by patients and care provided by informal caregivers, safety and quality standards may not be understood or achieved. The objectives and multidisciplinary nature of home health care services present challenges for measuring quality that differ from those found in a more traditional hospital environment. The CMS requires reporting on home health care outcome measures. The outcome-based quality monitoring (OBQM) program monitors, reports and compares adverse events, such as emergency care for injuries caused by falls or accidents, the increase in the number of pressure ulcers, and the substantial decrease of three or more ADLs.5 Available evidence suggests that, in addition to the use of APNs for the care of complex cases, traditional home health professionals, individually or interdisciplinary, can prevent unplanned hospital admissions with specific interventions. While researchers and other home care experts have recommended numerous strategies, most interventions have not been empirically tested.
There is also a need to further analyze the costs and benefits of the various interventions. The measurement of the costs of the intervention and the cost savings derived from avoided hospitalizations are not well understood. Some patient populations, due to the nature and complexity of the advanced disease process, may require more intensive and specialized home health care services that will not translate into cost savings. On the other hand, it has been demonstrated that the use of apparently more expensive transition resources, such as APNs, is cost-effective, although the adoption of these research-based best practices may be hampered by a lack of reimbursement and incentives 48. Research is needed to understand the impact of the transfer of care and the cost to home health care on patient outcomes and the fiscal position of the home health care sector.
They reported that higher patient satisfaction scores were more likely in home health care agencies, where nurses and supervisors had good working relationships, opportunities to make shared decisions, and organizational and professional guidelines were formalized. At each visit, the home care nurse will take the patient's vital signs, track symptoms and other details of the patient's condition, and administer medications or necessary treatments. When services begin, home health care staff will implement the plan, following all doctor's orders, and will keep the doctor informed of the patient's progress. Once you have a plan prescribed by a doctor, you can contact your health insurance company or work directly with an agency to set up the service.
If you are eligible for home health care, you can receive these services as directed by your doctor, in addition to having a caregiver. If you receive your Medicare benefits through a Medicare Advantage (Part C) plan or another Medicare health plan, check with your plan for more information about your home health benefits. Older people can often receive home health care in an assisted living facility, if they meet the eligibility requirements. Evidence on the outcomes of home health care is limited; there are very few controlled experiments that providers can base their practice on.
The interventions tested mainly consisted of increasing the intensity of care provided through a disease management program, a team-led home primary care program, an intervention by a specialized multidisciplinary team, the transient care of advanced practice nurses (APN), telehealth services and intensive rehabilitation care before hospital discharge. Home care doctors seek to provide safe, high-quality care in a way that respects patients' autonomy and is adapted to the individual characteristics of each patient's home and family. Rodriques and Megie80 found that 37 percent of injuries in home health care patients were pressure ulcers, with an average wound duration of nearly 27 months. This type of care may also include some form of help with activities of daily living (ADL), such as bathing, cooking, or light household chores, but it's important to keep in mind that, first and foremost, home health care is medical in nature.
Nursing care may include the placement of wound dressings, ostomy, intravenous therapy, administration of medications, monitoring the patient's general health, pain management, and other types of health support. Home health care providers generally accept Medicare and, in many cases, Medicare will pay for home health care if you are a current beneficiary and meet certain requirements. This chapter includes an analysis of the evidence on promoting patient safety and the quality of health care in relation to problems that are frequently seen in home health care.
