Unmet patient need in home care under managed care.
Social workers in home care agencies obtained through a national random sample responded to a mail questionnaire that examined the relationship between the frequency of discharge with unmet patient need and patient/family characteristics, agency auspice, and practice activities when social workers' assessment of patient needs and managed care payment limits conflict. Regression analysis found that the importance of social work financial planning with clients and intra-agency advocacy were significant negative contributors, and patient cognitive impairment, inadequate family care, and agency auspice were significant positive contributors to a regression model explaining 31 percent of the variance in the frequency of discharge with unmet need. Implications for practice, education, and research are discussed.
Kadushin
Goldie
G
School of Social Welfare, University of Wisconsin-Milwaukee, Enderis Hall, P.O. Box 786, Milwaukee, WI 53201, USA.
Egan
Marcia
M
D000368:Aged; D000369:Aged, 80 and over; D014487:Centers for Medicare and Medicaid Services, U.S.; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006699:Home Care Services / Q000191:economics / Q000458:organization & administration*; D006704:Homemaker Services; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration*; D006278:Medicare; D020380:Needs Assessment; D010351:Patient Discharge; D010548:Personal Health Services; D010865:Pilot Projects; D011445:Prospective Payment System; D012947:Social Work / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014481:United States