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Home Health Care Use and Post-Discharge Outcomes After Heart Failure Hospitalizations
Madeline R Sterling1, Lisa M Kern1, Monika M Safford1
1Weill Cornell Medicine, New York, New York, USA.
JACC. Heart Failure
|August 18, 2020
Summary
Home health care (HHC) use increased for Medicare heart failure (HF) patients post-discharge. HHC was linked to higher readmission and mortality risks, warranting cautious interpretation and further research.
Area of Science:
- Cardiology
- Health Services Research
- Geriatric Medicine
Background:
- Home health care (HHC) is utilized by some patients post-heart failure (HF) hospitalization.
- Factors influencing HHC use and its impact on patient outcomes remain understudied.
Purpose of the Study:
- To compare Medicare beneficiaries receiving HHC post-HF hospitalization with those who did not.
- To examine the association between HHC and subsequent readmission and mortality rates.
Main Methods:
- Utilized Get With The Guidelines-HF data merged with Medicare claims.
- Employed propensity score matching and Cox proportional hazards models.
- Analyzed data from 2005 to 2015, encompassing 95,531 HF admissions.
Main Results:
- HHC use increased from 31.4% to 36.1% between 2005-2015.
- HHC recipients were older, more often female, and had more comorbidities.
- HHC associated with increased 30-day and 90-day readmissions (all-cause and HF-specific) and mortality.
Conclusions:
- HHC utilization is rising among Medicare beneficiaries after HF hospitalization.
- HHC recipients tend to be older and have more severe health conditions.
- While HHC showed higher readmission and mortality risks, unmeasured factors necessitate cautious interpretation and further investigation into appropriate healthcare utilization.
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