Systematic research reviews of the international literature find that home health care is consistently effective in reducing mortality, restoring functional ability, and reducing long-term institutional care, but not much better than other settings or standard care in preventing hospitalization. US Medicare-certified home health agencies that use multi-component interventions including the National Campaign to Improve Home Health Quality have found slight or negligible decreases in hospitalization. ), Improving patient education and self-management, including interdisciplinary team management, and encouraging patient-centered care planning at the end of life.

The majority of formal home health care provided in the United States is compensated by Medicare or Medicaid in 60-day periods of time, or episodes of care. Payment for home health care is based on a thorough in-home assessment of the patient's medical and functional condition, and the need for skilled nursing or restorative treatment. During fiscal years 2008-2013, the Centers for Medicare and Medicaid Services (CMS) reduced the rate of home health care payments by 16% ($ 32 billion). Billion), and the Patient Protection and Affordable Care Act slashed payments by an additional 3.5% each year for the 2014-2017 period, and the impact of these cuts on home health was the subject of a focus group with managers of Medicare home health care agencies, who described management decisions that directly affect forces Home health nursing worker:

I fear the only way to get creative is to increase productivity and shorten stays. This will be challenging at a time when expectations of care are rising and employees may also face a pay freeze while their employees' share of health insurance costs increases. It is not a pretty picture.

Home health nurses work more hours than nurses almost anywhere else. Unlike home care assistants, home health nurses are often paid on a salary or fee basis, which makes them exempt from overtime and protection pay. Even when home health nurses are paid on an hourly basis, unpaid overtime to complete required documents is not rare. The additional productivity requirements that increase the workload of nurses, combined with other cost saving measures implemented by home health agencies, may increase the turnover of experienced nurses, and lead to a decrease in the quality of home health care. Research in acute care hospitals indicates that modifiable organizational factors, such as administrative support for nursing practice and better relationships with physicians, can have a significant impact on patient outcomes. Consideration must now be given to the effect of regulatory factors on patient outcomes in home health care.

Work environment in home health

In home care, as in hospitals, effective and effective nursing care requires adequate resources, administrative support, and group relationships with physicians, and other members of the multidisciplinary care team, and the elements of a good work environment include the conditions necessary to provide quality patient care and retain qualified personnel. Concretely, this indicates a sufficient number of staff and resources to provide safe and timely care to patients and cooperation between nurses and physicians is critical to improving patient care. Additionally, strong nursing leadership and administrative support alleviate work pressures and help create a culture where nurses listen to, support and advocate for patients, families and caregivers.

Author: Home care Greenville, South Carolina | Senior & Elderly Caregivers