Practice variations in home health care.
Wide variation in Medicare home care utilization became apparent in the 1990s. This study examined the impact of patient, provider, agency, and market factors on five measures of home care practice. Data were collected at 44 agencies in eight states. The final analysis sample included 732 home care episodes for which longitudinal patient data were available. Results indicated that patient factors, such as complexity and functional status, were important predictors of the care a patient received. Agency and market characteristics also strongly influenced care practices. Characteristics of the care providers, on the other hand, exerted only minimal influence.
Brega
Angela G
AG
Center for Health Services Research, Division of Health Care Policy and Research, School of Medicine, University of Colorado Health Sciences Center, Denver 80222, USA. Angela.Brega@uchsc.edu
Jordan
Anne K
AK
Schlenker
Robert E
RE
D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000191:economics; D017050:Episode of Care; D019981:Health Care Sector; D019538:Health Care Surveys; D006333:Heart Failure / Q000191:economics; D006699:Home Care Services / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008329:Managed Care Programs / Q000191:economics; D006278:Medicare / Q000331:legislation & jurisprudence*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011445:Prospective Payment System / Q000331:legislation & jurisprudence*; D012052:Reimbursement, Incentive / Q000331:legislation & jurisprudence*; D014481:United States