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Home Health Care Use and Post-Discharge Outcomes After Heart Failure Hospitalizations.

Publication ,  Journal Article
Sterling, MR; Kern, LM; Safford, MM; Jones, CD; Feldman, PH; Fonarow, GC; Sheng, S; Matsouaka, RA; DeVore, AD; Lytle, B; Xu, H; Allen, LA ...
Published in: JACC Heart Fail
December 2020

OBJECTIVES: This study compared the characteristics of Medicare beneficiaries who were hospitalized for heart failure (HF) and then discharged home who received home health care (HHC) to the characteristics of those who did not, and examined associations among HHC and readmission and mortality rates. BACKGROUND: After hospitalization for HF, some patients receive HHC. However, the use of HHC over time, the factors associated with its use, and the post-discharge outcomes after receiving it are not well studied. METHODS: This study used Get With The Guidelines-HF data, merged with Medicare fee-for-service claims. Propensity score matching and Cox proportional hazards models were used to evaluate the associations between HHC and post-discharge outcomes. RESULTS: From 2005 to 2015, 95,531 patients were admitted for HF, and 32,697 (34.2%) received HHC after discharge. The rate of HHC increased over time from 31.4% to 36.1% (p < 0.001). HHC recipients were older, more likely to be female, and had more comorbidities. HHC was associated with a higher risk of all-cause 30-day readmission (hazard ratio [HR]: 1.25; 95% confidence interval [CI]: 1.20 to 1.30), HF-specific 30-day readmission (HR: 1.20; 95% CI: 1.13 to 1.28), all-cause 90-day readmission (HR: 1.23; 95% CI: 1.19 to 1.26), HF-specific 90-day readmission (HR: 1.16; 95% CI: 1.11 to 1.22), and all-cause 30-and 90-day mortality, respectively (HR: 1.70; 95% CI: 1.56 to 1.86) and HR: 1.49; 95% CI: 1.41 to 1.57) compared to those who did not receive HHC. CONCLUSIONS: Use of HHC after HF hospitalization increased among Medicare beneficiaries. HHC recipients were older and sicker than non-HHC recipients. Although HHC was associated with a higher risk of readmissions and mortality, this finding should be interpreted cautiously, given the presence of unmeasured variables that could affect receipt of HHC. Research is needed to determine whether the results reflect appropriate health care use.

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Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

December 2020

Volume

8

Issue

12

Start / End Page

1038 / 1049

Location

United States

Related Subject Headings

  • United States
  • Patient Readmission
  • Patient Discharge
  • Medicare
  • Male
  • Humans
  • Hospitalization
  • Home Care Services
  • Heart Failure
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Sterling, M. R., Kern, L. M., Safford, M. M., Jones, C. D., Feldman, P. H., Fonarow, G. C., … Albert, N. M. (2020). Home Health Care Use and Post-Discharge Outcomes After Heart Failure Hospitalizations. JACC Heart Fail, 8(12), 1038–1049. https://doi.org/10.1016/j.jchf.2020.06.009
Sterling, Madeline R., Lisa M. Kern, Monika M. Safford, Christine D. Jones, Penny H. Feldman, Gregg C. Fonarow, Shubin Sheng, et al. “Home Health Care Use and Post-Discharge Outcomes After Heart Failure Hospitalizations.JACC Heart Fail 8, no. 12 (December 2020): 1038–49. https://doi.org/10.1016/j.jchf.2020.06.009.
Sterling MR, Kern LM, Safford MM, Jones CD, Feldman PH, Fonarow GC, et al. Home Health Care Use and Post-Discharge Outcomes After Heart Failure Hospitalizations. JACC Heart Fail. 2020 Dec;8(12):1038–49.
Sterling, Madeline R., et al. “Home Health Care Use and Post-Discharge Outcomes After Heart Failure Hospitalizations.JACC Heart Fail, vol. 8, no. 12, Dec. 2020, pp. 1038–49. Pubmed, doi:10.1016/j.jchf.2020.06.009.
Sterling MR, Kern LM, Safford MM, Jones CD, Feldman PH, Fonarow GC, Sheng S, Matsouaka RA, DeVore AD, Lytle B, Xu H, Allen LA, Deswal A, Yancy CW, Albert NM. Home Health Care Use and Post-Discharge Outcomes After Heart Failure Hospitalizations. JACC Heart Fail. 2020 Dec;8(12):1038–1049.
Journal cover image

Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

December 2020

Volume

8

Issue

12

Start / End Page

1038 / 1049

Location

United States

Related Subject Headings

  • United States
  • Patient Readmission
  • Patient Discharge
  • Medicare
  • Male
  • Humans
  • Hospitalization
  • Home Care Services
  • Heart Failure
  • Female