Toward a Strategy for Reducing Potentially Avoidable Hospital Admissions among Home Care Clients

Abstract

Cognizant of the disappointing health status effects of home care in past studies, the authors argue that home care (homemaker, chore, day care, and other personal care services) is ill equipped to alter health status but could alter the way in which patients, family, and physicians respond to health status changes. If it does this, it should be effective in preventing some of certain types of hospitalizations: those for death, nursing home placement, and evaluation. This study, which reanalyzes the National Channeling Demonstration Project data set to focus on these three most promising outcome effects of home care found that it did not prevent these types of potentially avoidable hospitalizations. Indeed, there is little evidence that such targeted preventive efforts took place. This may suggest that the objective function of home care should be redefined to focus on altering responses to health status change rather than on altering health status.