ArticleHealth services research2022
Patient cognitive impairment associated with higher home health care delivery costs.
Article in Health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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The trial behind it
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Who cites it
10 citing papers in PubMed.
- Quality of Medicare Skilled Home Health for People Living With Dementia in the US: National Patterns and Implications.Journal of the American Geriatrics Society · 2026Article
- Family Caregiver Availability and Capacity Associated With Home Health Service Types for Patients With Dementia.Journal of the American Medical Directors Association · 2025Article
- Cognitive Frailty and Health Care Utilization and Costs Among Middle-Aged and Older Adults: Findings from Four Longitudinal Cohort Studies.Aging and disease · 2025Article
- Skilled home healthcare utilization and outcomes for older adults with dementia: A scoping review.Journal of the American Geriatrics Society · 2025Article
- Patterns in health care use and intensity for diagnosed and undiagnosed cognitive impairment in the older australian community: Implications for primary care management.SSM - population health · 2024Article
- Incremental burden on health-related quality of life, health service utilization and direct medical expenditures associated with cognitive impairment among non-institutionalized people with diabetes aged 65 years and older.Diabetes, obesity & metabolism · 2024Article
- Prevalence and predictors of incident ADRD diagnosis following a Medicare home health episode.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Article
- Advancing the Research-to-Policy and Practice Pipeline in Aging and Dementia Care.The Public policy and aging report · 2023Article
- The Relative Importance of Hospital Discharge and Patient Composition in Changing Post-Acute Care Utilization and Outcomes Among Medicare Beneficiaries.Health services insights · 2023Article
- Patient cognitive impairment associated with higher home health care delivery costs.Health services research · 2022Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
objectiveTo assess whether home health agencies incur significantly higher care delivery costs for patients with cognitive impairment across three timeframes relevant to home health payment policy. DATA SOURCES: Linked Medicare home health claims and patient assessments, National Health and Aging Trends Study (NHATS), and home health agency cost reports for a nationally representative sample of Medicare beneficiaries receiving home health between 2011 and 2016. STUDY
designWe modeled care delivery costs incurred by the home health agency as a function of patient cognitive impairment using multivariable, propensity score-adjusted, generalized linear models. DATA COLLECTION/EXTRACTION
methodsWe identified NHATS participants who experienced an index home health episode between 2011 and 2016 (n = 1214; weighted n = 5,856,333) and linked their NHATS survey data to standardized patient assessment and claims data for the episode, as well as cost report data for the home health agency that provided care. PRINCIPAL
findingsAcross the first 30, 60, and 120 days of caring for a patient with cognitive impairment, we estimate additional costs of care to the home health agency of $186.19 (p = 0.02), $282.46 (p = 0.01), and $740.91 (p = 0.04), respectively.
conclusionsHome health agencies incur significantly higher costs when caring for a patient with cognitive impairment. As patient cognitive function is not considered in the most recent Medicare home health reimbursement model, agencies may be disincentivized from providing care to those with cognitive impairment. Policy makers and researchers should carefully monitor home health access among Medicare beneficiaries with cognitive impairment and further investigate the inclusion of patient cognitive function in future risk adjustment models.
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