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Related Experiment Videos

Decreased home health use: does it decrease satisfaction?

Nelda McCall1, Jodi Korb, Andrew Petersons

  • 1Laguna Research Associates.

Medical Care Research and Review : MCRR
|March 24, 2004
PubMed
Summary
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Medicare beneficiaries

Area of Science:

  • Health Services Research
  • Gerontology
  • Public Health Policy

Background:

  • The Balanced Budget Act (BBA) of 1997 introduced the Interim Payment System (IPS) for home health care.
  • This policy change significantly impacted service utilization and beneficiary experiences.

Purpose of the Study:

  • To investigate changes in Medicare beneficiary satisfaction and quality of life after IPS implementation.
  • To analyze the effects of the BBA's IPS on home health care recipients.

Main Methods:

  • Utilized pre- and post-BBA survey data from Medicare beneficiaries.
  • Employed multivariate analyses to control for beneficiary, agency, and community factors.
  • Assessed sixteen satisfaction variables and two quality of life indicators.

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Main Results:

  • No significant differences in overall agency satisfaction, discharge satisfaction, or satisfaction with nursing/therapist care were observed.
  • Some decreases in satisfaction were noted regarding interpersonal staff interactions and personal care services.
  • A notable increase in staff encouragement of patient independence was reported.

Conclusions:

  • The IPS implementation did not broadly decrease beneficiary satisfaction despite utilization changes.
  • Specific aspects of care, like personal services and interpersonal interactions, were affected.
  • The policy may have inadvertently fostered greater patient independence.