Background Medicare's home health care program, consisting primarily of home visits by nurses and health aides, was conceived as a means to facilitate hospital discharge.
Because home health care is now one of the fastest-growing categories of Medicare expenditures, we analyzed Medicare claims data to determine current patterns of use.
Methods We used 1993 data from Medicare's National Claims History File to examine the temporal relation between home visits and hospital discharge, as well as the number of months Medicare enrollees received home health care.
To determine whether home visits replaced hospital services, we calculated population-based utilization rates, adjusted for age and sex, for enrollees living in the 310 U.S. metropolitan statistical areas and determined whether the areas with higher rates of home health care also had lower admission rates or shorter lengths of stay.
Finally, we compared the geographic variation in use of home health care with that of other Medicare services.
Results Roughly 3 million Medicare enrollees received over 160 million home health care visits in 1993.
Seventy-eight percent of the visits either occurred more than a month after hospital discharge (35 percent) or were not associated with any in patient care during the previous six months (43 percent).
Home health care often represented a long-term intervention : 61 percent of the visits were to enrollees who received home health care for six months or more. (...)
Mots-clés Pascal : Soin, Ambulatoire, Service hospitalier, Etude comparative, Homme, Etats Unis, Amérique du Nord, Amérique, Visite
Mots-clés Pascal anglais : Care, Ambulatory, Hospital ward, Comparative study, Human, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0370581
Code Inist : 002B30A04A. Création : 10/04/1997.