ArticleJournal of the American Geriatrics Society2021
Utilization and Functional Outcomes Among Medicare Home Health Recipients Varied Across Living Situations.
Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 10 citations in OpenAlex.
- Does the Veterans Health Administration Purchase High-Quality Home Health Care?Journal of the American Medical Directors Association · 2025Observational
- Differences in Home Health Services and Outcomes Between Traditional Medicare and Medicare Advantage.JAMA health forum · 2024Article
- Home Health Agencies With More Socially Vulnerable Patients Have Poorer Experience of Care Ratings.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2022Article
- Risk factors for inpatient facility admission among home health care patients with diabetes.Nursing outlookArticle
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND/
objectivesHome health (HH) is a major type of home-based skilled care available to Medicare beneficiaries. We examined the association between living situation (home alone, home with others, and assisted living (AL) residence) and utilization and functional outcomes among Medicare HH recipients.
designAnalysis of national data from the Outcome and Assessment Information Set, HH Compare, Medicare claims, and Area Health Resource Files.
settingMedicare-certified HH agencies in the United States.
participantsNational population of Medicare beneficiaries ≥65 years old who received HH care in CY 2017 (N = 6,637,496). MEASUREMENTS: Outcomes included time-to-event measures of hospitalization and emergency department (ED) visits, and improvement in activities of daily living (ADL) from the start to the end of the HH admission.
resultsAL residents (12%) and patients living alone at home (24%) had longer survival time without hospitalization and ED visits than patients living with others at home (64%). Adjusting for covariates and HH agency-level random effects, and compared with patients living with others, AL residents had lower risk of hospitalization (hazard ratio (HR) = 0.85, P < .001) and ED visit (HR = 0.92, P < .001); however, less ADL improvement (β = 0.29 (29% less of total independence in one ADL)); and patients living alone had lower risk of hospitalization (HR = 0.94, P < .001) and ED visit (HR = 0.93, P < .001), yet more ADL improvement (β = -0.15 (15% more of total independence in one ADL)).
conclusionIn the national population of Medicare HH recipients, patients living with others at home had the highest risk of hospitalization and ED visits, whereas AL residents had the lowest risk of hospitalization and patients living alone at home had the lowest risk of ED visits, meaning that combined support from HH and AL reduces acute care admissions. Evidence-based interventions are needed for HH patients living with others at home to avoid unnecessary acute care use.
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