ArticleHealth services research2023
Informing a home time measure reflective of quality of life: A data driven investigation of time frames and settings of health care utilization.
Article in Health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- A stepped wedge cluster randomized trial to evaluate the effectiveness of a multisite family caregiver skills training program.Health services research · 2024Trial
- Balancing Days at Home and Major Adverse Limb Events After Surgical Versus Endovascular Lower-Extremity Revascularization in Chronic Kidney Disease.Journal of the American Heart Association · 2026Article
- Home Time Following Emergency Department Visits Among People With Dementia.JAMA network open · 2025Article
- Article
- The Incidence of Poor Postoperative Recovery Characterized Using 'Days Alive and Out of Hospital' in Octogenarians and Nonagenarians-A Retrospective Cohort Study.Journal of clinical medicine · 2025Article
- Quality-of-life factors at home and in health care settings for people living with dementia.The Gerontologist · 2025Article
- Geriatrics-Focused vs Traditional Primary Care in the Veterans Affairs Health Care System.JAMA network open · 2025Article
- Is more care recipient time at home also a family caregiver-centered quality of life measure?Journal of the American Geriatrics Society · 2024Article
- The association between social risks and days at home for older veterans.Journal of the American Geriatrics Society · 2024Article
- Informing a home time measure reflective of quality of life: A data driven investigation of time frames and settings of health care utilization.Health services research · 2023Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
objectiveTo evaluate short- and long-term measures of health care utilization-days in the emergency department (ED), inpatient (IP) care, and rehabilitation in a post-acute care (PAC) facility-to understand how home time (i.e., days alive and not in an acute or PAC setting) corresponds to quality of life (QoL). DATA SOURCES: Survey data on community-residing veterans combined with multipayer administrative data on health care utilization. STUDY
designVA or Medicare health care utilization, quantified as days of care received in the ED, IP, and PAC in the 6 and 18 months preceding survey completion, were used to predict seven QoL-related measures collected during the survey. Elastic net machine learning was used to construct models, with resulting regression coefficients used to develop a weighted utilization variable. This was then compared with an unweighted count of days with any utilization. PRINCIPAL
findingsIn the short term (6 months), PAC utilization emerged as the most salient predictor of decreased QoL, whereas no setting predominated in the long term (18 months). Results varied by outcome and time frame, with some protective effects observed. In the 6-month time frame, each weighted day of utilization was associated with a greater likelihood of activity of daily living deficits (0.5%, 95% CI: 0.1%-0.9%), as was the case with each unweighted day of utilization (0.6%, 95% CI: 0.3%-1.0%). The same was true in the 18-month time frame (for both weighted and unweighted, 0.1%, 95% CI: 0.0%-0.3%). Days of utilization were also significantly associated with greater rates of instrumental ADL deficits and fair/poor health, albeit not consistently across all models. Neither measure outperformed the other in direct comparisons.
conclusionsThese results can provide guidance on how to measure home time using multipayer administrative data. While no setting predominated in the long term, all settings were significant predictors of QoL measures.
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