Featured Research

from universities, journals, and other organizations

Seniors moving to homecare based services face more hospital risk

Date:
January 8, 2014
Source:
Brown University
Summary:
Community and home-based care services are popular and cost Medicaid less money than nursing home care, but a new study finds that seniors who left the nursing home for such services were 40 percent more likely to become hospitalized for a potentially preventable reason than those who stayed in the nursing home.

Seniors want greater access to home- and community-based long-term care services. Medicaid policymakers have been happy to oblige with new programs to help people move out of expensive nursing homes and into cheaper community or home care. It seems like a "win-win" to fulfill seniors' wishes while also saving Medicaid programs money, but a new study of such transitions in seven states finds that the practice resulted in a 40 percent greater risk of "potentially preventable" hospitalizations among seniors dually eligible for Medicaid and Medicare.

Related Articles


"We are trying to move people into the community and I think that is a really great goal, but we aren't necessarily providing the medical support services that are needed in the community," said Andrea Wysocki, a postdoctoral scholar in the Brown University School of Public Health and lead author of the study published online in the Journal of the American Geriatrics Society. "One of the policy issues is how do we care for not only the long-term care needs when we move someone into home- and community-based settings but also how do we support their medical needs as well?"

Wysocki said her finding of a higher potentially preventable hospitalization risk for seniors who transitioned to community- or home-based care suggests that some medical needs are not as well addressed in community settings as they are in nursing homes. More vigilant and effective treatment for chronic, already-diagnosed ailments such as chronic obstructive pulmonary disease could prevent some of the hospitalizations that occur.

There are two likely reasons why care in home and community settings is not as effective in preventing hospitalizations, Wysocki said. Nursing homes provide round-the-clock care by trained nurses and doctors, but workers with much less medical training provide community- and home-care services. In addition, while Medicaid pays for long-term care, Medicare pays for medical care, meaning that Medicaid programs do not have a built-in financial incentive to prevent hospitalizations. Home- and community-based care is less expensive for Medicaid regardless of the medical outcome.

Careful comparison

Wysocki performed the analysis for her doctoral thesis work at the University of Minnesota. She and her co-authors looked at a set of records provided by the Centers for Medicare and Medicaid Services of thousands of dually eligible seniors from Arkansas, Florida, Minnesota, New Mexico, Texas, Vermont, and Washington who entered nursing homes between 2003 and 2005.

Based on those records, Wysocki and her team determined who made the transition to community and home care and who stayed in the nursing home. Accounting for a wide variety of demographic and medical factors, they then compared the rate of hospitalizations among 1,169 seniors who transitioned to the community ("transitioners") and 1,169 otherwise similar seniors who stayed in the nursing home ("stayers").

What Wysocki observed was that 133 transitioners ended up hospitalized for potentially preventable reasons, while only 113 stayers did. Including "non-preventable" hospitalizations, the numbers rose to 419 among transitioners and 297 among stayers.

Those raw numbers don't quite tell the whole story in comparing overall hospitalization risk, however, because seniors in the stayers group also generally took a longer time to reach that first hospitalization than seniors in the transitioners group. Using a standard statistical technique to account for the time difference, Wysocki found that transitioners faced a 40-percent greater risk of enduring a potentially preventable hospitalization and a 58-percent greater risk of any kind of hospitalization than the stayers did.

Making care less fragmented

The study, published Jan. 2, 2014, concludes with a clear recommendation: "Ensuring that an individual has long-term care and medical providers and a care plan at the time of transition may keep them out of the hospital and result in more successful long-term outcomes."

Whether that happens is ultimately up to the payers, Medicaid and Medicare. Wysocki said demonstration programs in which the two programs work in concert, rather than separately to address the issue are underway and merit watching.


Story Source:

The above story is based on materials provided by Brown University. Note: Materials may be edited for content and length.


Journal Reference:

  1. Andrea Wysocki, Robert L. Kane, Bryan Dowd, Ezra Golberstein, Terry Lum, Tetyana Shippee. Hospitalization of Elderly Medicaid Long-Term Care Users Who Transition from Nursing Homes. Journal of the American Geriatrics Society, 2013; DOI: 10.1111/jgs.12614

Cite This Page:

Brown University. "Seniors moving to homecare based services face more hospital risk." ScienceDaily. ScienceDaily, 8 January 2014. <www.sciencedaily.com/releases/2014/01/140108102439.htm>.
Brown University. (2014, January 8). Seniors moving to homecare based services face more hospital risk. ScienceDaily. Retrieved November 23, 2014 from www.sciencedaily.com/releases/2014/01/140108102439.htm
Brown University. "Seniors moving to homecare based services face more hospital risk." ScienceDaily. www.sciencedaily.com/releases/2014/01/140108102439.htm (accessed November 23, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Sunday, November 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

WFP: Ebola Risks Heightened Among Women Throughout Africa

WFP: Ebola Risks Heightened Among Women Throughout Africa

AFP (Nov. 21, 2014) Having children has always been a frightening prospect in Sierra Leone, the world's most dangerous place to give birth, but Ebola has presented an alarming new threat for expectant mothers. Duration: 00:37 Video provided by AFP
Powered by NewsLook.com
Could Your Genes Be The Reason You're Single?

Could Your Genes Be The Reason You're Single?

Newsy (Nov. 21, 2014) Researchers in Beijing discovered a gene called 5-HTA1, and carriers are reportedly 20 percent more likely to be single. Video provided by Newsy
Powered by NewsLook.com
Raw: Paralyzed Marine Walks With Robotic Braces

Raw: Paralyzed Marine Walks With Robotic Braces

AP (Nov. 21, 2014) Marine Corps officials say a special operations officer left paralyzed by a sniper's bullet in Afghanistan walked using robotic leg braces in a ceremony to award him a Bronze Star. (Nov. 21) Video provided by AP
Powered by NewsLook.com
Milestone Birthdays Can Bring Existential Crisis, Study Says

Milestone Birthdays Can Bring Existential Crisis, Study Says

Newsy (Nov. 21, 2014) Researchers find that as people approach new decades in their lives they make bigger life decisions. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins