title: A randomized trial of Veterans Administration home care for severely disabled veterans.
abstract: This randomized study screened hospital admissions to all wards except Psychiatry and Spinal Cord Injured during a 3-year period to identify 233 severely disabled patients (2 impairments on the Katz Index of ADL) and caregivers who were willing to participate in a pretest-multiple posttest trial of the Hines VA Hospital-based Home Care (HBHC) Program. Patient functional status, morale, and satisfaction with care were measured at baseline, 1 month and 6 months post discharge. Caregiver satisfaction and morale were assessed at the same time periods. All health care services used by both groups were tracked over the 6-month period and converted to cost. Findings include improved 1-month satisfaction with care (P = 0.04) and improved 6-month cognitive functioning (P = 0.04) among HBHC patients and improved 1-month (P = 0.04) and 6-month satisfaction with care (P less than 0.01) among their caregivers. A nonsignificant 10% decrease in net cost of care, was found in the treatment group, largely due to lower use of private sector hospital care.
authors.affiliation: Center for Health Services and Policy Research, Northwestern University, Evanston, IL 60201.
authors.forename: S L
authors.initials: SL
authors.lastname: Hughes
authors.forename: J
authors.initials: J
authors.lastname: Cummings
authors.forename: F
authors.initials: F
authors.lastname: Weaver
authors.forename: L M
authors.initials: LM
authors.lastname: Manheim
authors.forename: K J
authors.initials: KJ
authors.lastname: Conrad
authors.forename: K
authors.initials: K
authors.lastname: Nash
mesh_terms: D000359:Aftercare / Q000191:economics* / Q000592:standards; D000368:Aged; D003071:Cognition; D003258:Consumer Behavior / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D006233:Persons with Disabilities; D006699:Home Care Services / Q000191:economics* / Q000592:standards; D006801:Humans; D007087:Illinois; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D011897:Random Allocation; D014728:Veterans