The Costs of Home Health and Patient Outcomes

家庭健康的成本和患者的治疗结果

• 批准号: 9164927
• 负责人: DANA B MUKAMEL
• 金额: $ 63.19万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9164927
• 关键词: Address; Affordable Care Act; Aging; Care given by nurses; Caring; Characteristics; Charge; Chronic Disease; Data; Data Analyses; Data Reporting; Data Set; Dimensions; Economics; Effectiveness; Elderly; Electronic Mail; Environment; Exhibits; Expenditure; Goals; Health; Health Care Costs; Health Personnel; Healthcare Systems; Home Care Services; Home Health Agency; Home environment; Hospitalization; Incentives; Individual; Industry; Investigation; Knowledge; Letters; Link; Marketing; Measures; Medicare; Medicare claim; Medicare/Medicaid; Methodology; Methods; Modality; National Institute on Aging; Online Systems; Outcome; Ownership; Patient Preferences; Patient-Focused Outcomes; Patients; Perception; Performance; Policies; Policy Maker; Production; Prospective Payment System; Provider; Quality of Care; Reporting; Research; Sampling; Science; Specific qualifier value; Surveys; System; Techniques; Technology; Testing; Travel; Update; aging population; base; cost; cost effective; cost effectiveness; design; evidence base; hospice environment; improved; improved outcome; insight; meetings; patient home care; payment; response; trend; web app

PROJECT SUMMARY/ABSTRACT The elderly and those suffering from chronic disease increasingly rely on home health care (HH). Over the last decade, the number of home health agencies (HHAs) has increased by over 50% and expenditures have doubled. These trends are expected to continue as technology allows more individuals to receive care at home, and as payers and providers are looking for cost efficiencies. Developing the science and identifying the policies that will allow the elderly to maximize their health and independence in cost effective ways is a major theme of the NIA's “Strategic Directions for Research on Aging,” and the CMS policy as directed by the Affordable Care Act (ACA). ACA specifically calls for CMS to update the HH payment system to reflect factors influencing costs, health outcomes being a major one, and to undertake studies to develop the evidence base to support such updates. This project is designed to contribute to the evidence base linking costs and patients' health outcomes. This project will investigate the relationship between costs and patient health outcomes in HH through the study of cost functions. It will link primary and secondary data. A national web-based survey will be administered to 12,000 HHAs nationally. The survey will be sponsored and sent out by the National Association of Home Care & Hospice (NAHC). Survey responses will be linked to national OASIS and cost reports data to create a unique dataset, which will allow investigation of the costs and effectiveness of specific improvement strategies and actions. The study will employ sophisticated econometric techniques to estimate cost functions for HHAs. The project is also proposing to disseminate its finding to HHAs, policy makers, and others through a newly developed web-based application that would allow the user to obtain preliminary estimates of effectiveness and costliness of improvement initiatives under user specified scenarios. This app will be based on the relationships estimated in the first part of the project. Throughout, the project will benefit from the support and advice of a NAHC National Advisory Group composed of directors and financial officers of HHAs nationally. The knowledge generated by this project will inform policy makers and HHAs about the relationships between costs and patient health outcomes in different types of agencies and markets and will offer important guidance and insights to policies designed to incentivize efficient and effective care.

项目概要/摘要 老年人和慢性病患者越来越依赖家庭医疗保健 (HH)。 过去十年，家庭健康机构 (HHA) 的数量增加了 50% 以上，支出增加 随着技术允许更多的人接受护理，这些趋势预计将持续下去。 家庭，付款人和提供者正在寻求成本效率。 允许老年人以具有成本效益的方式最大限度地实现健康和独立的政策是一项 NIA 的“老龄化研究战略方向”的主题以及 CMS 政策 《平价医疗法案》(ACA) 特别要求 CMS 更新 HH 支付系统以反映因素。 成本、健康结果是主要影响因素，并进行研究以建立证据基础 支持此类更新。该项目旨在为连接成本和患者的证据基础做出贡献。 健康结果。 该项目将通过以下方式调查 HH 的成本与患者健康结果之间的关系： 成本函数的研究将连接主要和次要数据。 该调查将由国家卫生健康局赞助并发送给全国 12,000 个 HHA。 家庭护理和临终关怀协会 (NAHC) 的调查回复将与国家 OASIS 和成本挂钩。 报告数据以创建独特的数据集，这将允许调查特定的成本和有效性 该研究将采用复杂的计量经济学技术来估计。 HHA 的成本函数。 该项目还建议通过以下方式向 HHA、政策制定者和其他人传播其发现： 新开发的基于网络的应用程序，允许用户获得初步估计 该应用程序将基于用户指定场景下的改进举措的有效性和成本。 关于项目第一部分中估计的关系。 自始至终，该项目都将受益于 NAHC 国家咨询小组的支持和建议 由全国 HHA 的董事和财务官员组成。 该项目产生的知识将向政策制定者和 HHA 通报这些关系 不同类型机构和市场的成本和患者健康结果之间的关系，并将提供重要的信息 对旨在激励高效和有效护理的政策的指导和见解。