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Home health outcome patterns
Robert E Schlenker1, Martha C Powell, Glenn K Goodrich
1Center for Health Services Research, Division of Health Care Policy and Research, Department of Medicine, School of Medicine, University of Colorado Health Sciences Center, Aurora 80011, USA. Bob.Schlenker@UCHSC.edu
Home Health Care Services Quarterly
|September 29, 2004
Summary
Medicare prospective payment implementation impacted patient outcomes. Aggregate outcome ratios show promise for assessing agency performance, but individual outcome data remains crucial for improvement efforts.
Area of Science:
- Healthcare Management
- Health Services Research
- Quality Improvement
Background:
- Medicare prospective payment system (PPS) implementation in home health agencies aimed to standardize reimbursement and incentivize efficiency.
- Assessing agency performance based on patient outcomes is critical for quality improvement and accountability.
- The OASIS (Outcome and Assessment Information Set) data provides a rich source for evaluating home health agency performance.
Purpose of the Study:
- To present descriptive statistics on patient outcomes for Medicare-certified home health agencies in 2001.
- To evaluate the utility of aggregated outcome ratios as indicators of agency performance.
- To examine the interrelationships between different patient outcome measures.
Main Methods:
- Utilized OASIS data from a national sample of Medicare-certified home health agencies in 2001.
- Calculated descriptive statistics for various patient outcomes.
- Computed ratios of actual to predicted outcome rates, aggregated across outcome groups, to assess agency performance.
Main Results:
- Descriptive statistics on patient outcomes were presented for the national agency sample.
- Aggregate ratios of actual to predicted outcome rates demonstrated potential as summary indicators of agency performance.
- Individual outcome data was found to be critical for targeted agency improvement efforts.
- Interrelationships were observed between ratios for certain outcomes.
Conclusions:
- Aggregate outcome ratios offer a promising approach to summarizing home health agency performance.
- Despite the utility of aggregate ratios, detailed information on individual outcomes is essential for effective quality improvement.
- Improving targeted outcomes may lead to concurrent improvements in related patient outcomes, suggesting strategic focus areas for agencies.