title: Continuity in home health care: is consistency in nursing personnel associated with better patient outcomes?
abstract: A growing body of evidence suggests that patients who receive coordinated and uninterrupted health care services have better outcomes, more efficient resource utilization, and lower costs of health care. However, limited research has considered whether attributes of continuity in home health care service delivery are associated with improved patient outcomes. The present study examines the relationship between one dimension of continuity of care, consistency in nursing personnel, and three patient outcomes: hospitalization, emergent care, and improvement in activities of daily living. Analyses of data from a large population of home health patients (N=59,854) suggest that greater consistency in nursing personnel decreases the probability of hospitalization and emergent care, and increases the likelihood of improved functioning in activities of daily living between admission and discharge from home health care. These results provide preliminary evidence that efforts to decrease dispersion of nursing personnel across a series of home visits to patients may lead to improved outcomes. The implications of these findings for clinical practice and further research are discussed in the paper.
authors: Center for Home Care Policy & Research, Visiting Nurse Service of New York, NY, USA. David.Russell@vnsny.org
authors: David
authors: D
authors: Russell
authors: Robert J
authors: RJ
authors: Rosati
authors: Peri
authors: P
authors: Rosenfeld
authors: Joan M
authors: JM
authors: Marren
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D003266:Continuity of Patient Care / Q000592:standards*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009740:Nursing Staff / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data; D014481:United States