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Physician Evaluation and Management of Medicare Home Health Patients

Bibliographic Data

ID9104041
AuthorsJennifer L Wolff, Jennifer C Wolff (0000-0002-7898-3903, Centers for Medicare and Medicaid Services, corresponding author), Ann Meadow (Centers for Medicare and Medicaid Services), Cynthia M Boyd (0000-0001-5642-9015, Johns Hopkins Medicine, corresponding author), Carlos O Weiss (Johns Hopkins University), Bruce Leff (0000-0003-1714-7458, Johns Hopkins Medicine, corresponding author)
Year2009
Volume47
Issue11
Pages1147-1155
Publication date2009-11-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3181b58e30
PMID19786916
OpenAlexW2034699778
LanguageEN
Citations received1
References cited28

OBJECTIVE: The Medicare home health benefit is predicated on physician referral and involvement. In this study, we investigated (1) the frequency and (2) implications of home health patients' evaluation and management by community physicians. METHODS: The 2005 and 2006 Medicare 5% Standard Analytic Files were linked to the Outcome and Assessment Information Set to examine physician visits among 74,462 fee-for service Medicare beneficiaries with a home health episode of care between July 1, 2005 and December 1, 2006. We examined whether receipt of community physician evaluation and management visits by home health patients was associated with subsequent discharge disposition, comparing discharge from the agency as opposed to inpatient facility transfer. RESULTS: More than one-third (34.6%) of patients did not receive physician evaluation and management visits during their home health episode. Home health patients most commonly incurred physician office visits exclusively (51.5%) or in combination with consultations (6.8%) or house call visits (2.2%), as well as house call visits exclusively (3.3%). Patients who incurred physician evaluation and management visits during their episode of care were more likely to be discharged from home health agencies than their counterparts who did not (77.9% vs. 70.6%, respectively). The association between physician visits and home health discharge was statistically significant in both simple regression models (odds ratio = 1.47; 95% confidence interval [CI], 1.42-1.52) and in multivariate analyses accounting for socio-demographic factors, health, and functioning (odds ratio = 1.45; 95% CI, 1.40-1.51). CONCLUSIONS: More systematic integration of physicians in home care processes may reduce subsequent hospital and other inpatient facility use among home health patients

Family medicine · MEDLINE · Frailty in Older Adults · Geriatric Care and Nursing Homes · Health disparities and outcomes · Medicine

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Unique citing works1
Citations per year0,14
Citation span2019 - 2019 (1)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 1
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