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Research Studies is a compilation of published research articles funded by 大象APPor authored by 大象APPresearchers.

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1 to 25 of 157 Research Studies Displayed
Topaz M, Davoudi A, Evans L
Building a time-series model to predict hospitalization risks in home health care: insights into development, accuracy, and fairness.
This study aimed to develop a time-series risk model to predict hospitalizations and emergency department (ED) visits in patients in home healthcare (HHC), examine model performance over various prediction windows, identify top predictive variables and map them to data standards, and assess model fairness across demographic subgroups. The authors looked at a total of 27,222 HHC adverse episodes that occurred between 2015 and 2017. Using Medicare claims data, the study used health care process modeling of electronic health records, including clinical notes processed with natural language processing techniques. A risk prediction model was developed using a Light Gradient Boost Machine algorithm. The model achieved high predictive performance, with 20 top predictive variables identified. A large majority (85%) of these variables mapped completely to the US Core Data for Interoperability standard. There were performance disparities across demographic and socioeconomic groups, with lower model effectiveness for more historically underserved populations.
AHRQ-funded; HS027742.
Citation: Topaz M, Davoudi A, Evans L . Building a time-series model to predict hospitalization risks in home health care: insights into development, accuracy, and fairness. J Am Med Dir Assoc 2025 Feb; 26(2):105417. doi: 10.1016/j.jamda.2024.105417..
Keywords: Home Healthcare, Hospitalization, Risk
Chae S, Davoudi A, Song J
Developing a clinical decision support framework for integrating predictive models into routine nursing practices in home health care for patients with heart failure.
This research developed a clinical decision support framework for heart failure patients in home health care who frequently experience hospitalizations due to symptom progression and comorbidities. Using data from 9,362 patients across 12,223 care episodes from a northeastern US home health organization, researchers identified key predictors of emergency department visits and hospitalizations. Time since home health care admission and recent heart failure symptoms emerged as significant predictors, with data from the most recent visits proving particularly valuable. The proposed artificial intelligence-based tool aims to alert nurses about emerging risks to facilitate timely interventions and prevent adverse events.
AHRQ-funded; HS027742.
Citation: Chae S, Davoudi A, Song J . Developing a clinical decision support framework for integrating predictive models into routine nursing practices in home health care for patients with heart failure. J Nurs Scholarsh 2025 Jan; 57(1):165-77. doi: 10.1111/jnu.13030..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Home Healthcare, Cardiovascular Conditions, Nursing
Johnson JK, Rothberg MB, Dalton JE
High-intensity home-based rehabilitation in聽a聽Medicare accountable care organization.
This study鈥檚 objective was to compare outcomes for episodes in a novel high-intensity home-based rehabilitation (HIHR) model versus a skilled nursing facility (SNF). This retrospective cohort study used data from Medicare patients from a large integrated multihospital health system who had low to moderate medical complexity and mild to moderate mobility deficits at hospital discharge. Primary outcome was the Activity Measure for Post-Acute Care (AM-PAC) mobility score, and secondary outcomes Medicare costs within 30- and 90-days post hospitalization, 30-day readmission rate, and index hospital length of stay (LOS). A total of 912 patients were included with 171 discharged to HIHR and 841 to SNFs. The adjusted AM-PAC mobility T-score was 8.2 points higher after HIHR versus SNF. Adjusted Medicare costs were lower for the HIHR cohort (within 90 days, -$17,123). There was no difference between hospital LOS and odds for readmission.
AHRQ-funded; HS028529.
Citation: Johnson JK, Rothberg MB, Dalton JE . High-intensity home-based rehabilitation in聽a聽Medicare accountable care organization. Am J Manag Care 2025 Jan; 31(1):12-18. doi: 10.37765/ajmc.2025.89660..
Keywords: Home Healthcare, Medicare
Kramer J, Kowalkowski M, Reeves K
Patient and care team perspectives on an app to support Hospital at Home admission decision making.
This study evaluated a shared decision-making app designed to assist pneumonia patients considering Hospital at Home (HaH) admission. Researchers conducted usability surveys with 16 participants and semi-structured interviews with 9 patients and 3 nurse navigators across three southeastern U.S. hospitals. Patients responded positively to receiving HaH information through the app, particularly appreciating its multi-modal content through videos, pictures, and text. The app's inquiries into care preferences helped patients clarify priorities and enhanced their sense of agency while providing valuable information to care teams. Visual elements effectively conveyed program details such as the in-home setup, potentially addressing health literacy challenges. However, participants identified potential barriers regarding accessibility for visually impaired and non-English speaking patients.
AHRQ-funded; HS027248.
Citation: Kramer J, Kowalkowski M, Reeves K . Patient and care team perspectives on an app to support Hospital at Home admission decision making. J Hosp Med 2025 Jan; 20(1):42-50. doi: 10.1002/jhm.13475.
Keywords: Home Healthcare, Shared Decision Making, Health Information Technology (HIT)
Murad MH, Nayfeh T, Saadi S
Home and community-based services: a systematic review and evidence map.
This systematic review provides an evidence map of the existing literature on home and community-based services (HCBS) for adults aged 60 years or older, identifying evidence gaps for policy and research. HCBS populations were categorized as those with functional disability, cognitive impairment, high-risk/frail conditions, and disease-specific conditions (Parkinson's disease, Alzheimer's disease, and post-stroke). Interventions targeted optimization of person-centered planning, nonpharmacological approaches for dementia care, physical rehabilitation, self-directed home care, geriatric resources for practical support at home, and interdisciplinary care coordination for high-risk conditions. Key challenges in the HCBS literature included limited number of randomized trials, inadequate descriptions of interventions to determine person-centeredness, limited information on facilitators and barriers, and limited information on workforce challenges in recruiting, retaining, and training personnel delivering HCBS.
AHRQ-funded; .75Q80120D00005.
Citation: Murad MH, Nayfeh T, Saadi S . Home and community-based services: a systematic review and evidence map. J Gen Intern Med 2024 Dec; 39(16):3315-21. doi: 10.1007/s11606-024-08993-3..
Keywords: Community-Based Practice, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Home Healthcare
Oladapo-Shittu O, Klein EY, Shpitser I
CLABSI surveillance in home infusion: importance of a standardized definition for improvement.
This research paper described the work of the Home Infusion CLABSI Prevention Collaborative, a group of five home infusion agencies that came together to learn from each other about CLABSI prevention in home infusion. They held monthly meetings for 6 years to discuss topics that included new innovations and strategies to overcome common barriers. Early in the Collaborative, they recognized that there was no standardized mechanism to measure CLABSI in home infusion therapy. The group developed a candidate HI-CLABSI surveillance definition, based in part on the National Healthcare Safety Network (NHSN) acute-care surveillance definition. The definition needed to be validated, and part of the challenge was how to manage secondary bloodstream infections. Therefore, they decided to describe HI-CLABSI (1) where all NHSN-defined secondary bloodstream infections were excluded, (2) only the four most common NHSN-defined secondary bloodstream infections were excluded, and (3) where no secondary bloodstream infections were excluded. All three variations were found to be valid.
AHRQ-funded; HS027819.
Citation: Oladapo-Shittu O, Klein EY, Shpitser I . CLABSI surveillance in home infusion: importance of a standardized definition for improvement. Home Healthc Now 2024 Nov-Dec; 42(6):368-70. doi: 10.1097/nhh.0000000000001306.
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Home Healthcare
Xu Z, Evans L, Song J
Exploring home healthcare clinicians' needs for using clinical decision support systems for early risk warning.
This study鈥檚 objective was to explore home healthcare (HHC) clinicians' needs for Clinical Decision Support Systems (CDSS) information delivery for early risk warning within HHC workflows. Using the CDS 鈥淔ive-Rights鈥 framework as a guide, the authors conducted semi-structured interviews with 13 multidisciplinary clinicians. The interviews yielded 16 codes mapping to the CDS "Five-Rights" framework (right information, right person, right format, right channel, right time) and 11 codes for unintended consequences and training needs. Clinicians favored risk levels displayed in color-coded horizontal bars and preferred non-intrusive risk alerts requiring mandatory confirmation. They anticipated risk information updates aligned with patient's condition severity and their visit pace, and also requested training to understand the CDSS's underlying logic and raised concerns about information accuracy and data privacy.
AHRQ-funded; HS027742.
Citation: Xu Z, Evans L, Song J . Exploring home healthcare clinicians' needs for using clinical decision support systems for early risk warning. J Am Med Inform Assoc 2024 Nov; 31(11):2641-50. doi: 10.1093/jamia/ocae247.
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Home Healthcare, Risk
Kowalkowski M, Eaton T, Reeves KW
Incorporating patient, caregiver, and provider perspectives in the co-design of an app to guide Hospital at Home admission decisions: a qualitative analysis.
This study assessed user needs and perspectives to guide early prototyping and co-creation of 4PACS (Partnering Patients and Providers for Personalized Acute Care Selection), a decision support app to help patients make an informed decision when presented with discrete hospitalization options to help with Hospital at Home (HaH) programs. They interviewed 12 stakeholders (3 patients, 2 caregivers, 7 providers [physicians/nurse]). They identified 4 primary themes: attitudes about HaH; 4PACS app content and information needs; barriers to 4PACS implementation; and facilitators to 4PACS implementation. They characterized 3 user descriptions (one per stakeholder group) to support 4PACS design decisions. User needs identified included patient selection criteria, clear program details, and descriptions of HaH components to inform care expectations. Implementation barriers included conflict between app recommendations and clinical judgement, inability to adequately represent patient-risk profile, and provider burden. Implementation facilitators emphasized ease-of-use, auto-populating features, and appropriate health literacy.
AHRQ-funded; HS027248.
Citation: Kowalkowski M, Eaton T, Reeves KW . Incorporating patient, caregiver, and provider perspectives in the co-design of an app to guide Hospital at Home admission decisions: a qualitative analysis. JAMIA Open 2024 Oct; 7(3):ooae079. doi: 10.1093/jamiaopen/ooae079..
Keywords: Hospital Discharge, Home Healthcare, Transitions of Care, Health Information Technology (HIT), Shared Decision Making, Caregiving
Zimbroff RM, Deardorff WJ, Song S
Use of a financial incentive code for in-home COVID-19 vaccination of homebound older adults.
This cross-sectional study evaluated uptake of the Healthcare Common Procedure Coding System code M0201-- designed to incentivize in-home COVID-19 vaccination for homebound fee-for-service Medicare beneficiaries -- to inform future in-home preventive care policy. Data from the CMS Provider Utilization and Payment Data Physician & Other Practitioners dataset indicated that M0201 was used predominantly by pharmacies and in metropolitan areas in the first 6 months after implementation and may incentivize mass immunizers who have resources to increase the volume of in-home vaccinations.
AHRQ-funded; HS026383.
Citation: Zimbroff RM, Deardorff WJ, Song S . Use of a financial incentive code for in-home COVID-19 vaccination of homebound older adults. JAMA 2024 Jul 16; 332(3):252-54. doi: 10.1001/jama.2024.9673..
Keywords: COVID-19, Vaccination, Home Healthcare, Elderly
Gustavson AM, Horstman MJ, Cogswell JA
Caregiver recruitment strategies for interventions designed to optimize transitions from hospital to home: lessons from a randomized trial.
This article described different recruitment processes and compared diversity in recruitment rates within the context of a care recipient's hospitalization. The findings showed that rates for in-person versus virtual family caregiver recruitment were 28% and 23%, respectively; family caregivers recruited virtually were more likely to be younger, white, have education levels beyond high school, and not be a spouse or significant other to the care recipient. The authors concluded that future work is needed to identify the modality and timing of family caregiver recruitment to maximize rates and enhance the representativeness of the population for equitable impact.
AHRQ-funded; HS026379.
Citation: Gustavson AM, Horstman MJ, Cogswell JA . Caregiver recruitment strategies for interventions designed to optimize transitions from hospital to home: lessons from a randomized trial. Trials 2024 Jul 4; 25(1):454. doi: 10.1186/s13063-024-08288-2..
Keywords: Caregiving, Transitions of Care, Home Healthcare, COVID-19
Jacobs PD
大象APPAuthor: Jacobs PD
In-home health risk assessments and chart reviews contribute to coding intensity In Medicare Advantage.
This study investigated the potential use of in-home health risk assessments and chart reviews for diagnosis used in Medicare Advantage, that are not currently available to beneficiaries in traditional Medicare. The author isolated the impact of these two types of encounters on the risk scores used for payments to MA plans during 2016-2021. They found that encounter-based risk scores for MA enrollees were higher by 0.091 points, or 7.4 percent, than in 2021 when in-home health risk assessments and chart reviews were included than they would have been without the use of these tools.
AHRQ-authored.
Citation: Jacobs PD . In-home health risk assessments and chart reviews contribute to coding intensity In Medicare Advantage. Health Aff 2024 Jul; 43(7):942-49. doi: 10.1377/hlthaff.2023.01530..
Keywords: Medicare, Home Healthcare
Thompson MP, Hou H, Likosky DS
Home health care use and outcomes after coronary artery bypass grafting among Medicare beneficiaries.
This study investigated home health care (HHC) usage among Medicare beneficiaries after coronary artery bypass grafting (CABG) and its impact on outcomes. Analyzing data from 77,331 beneficiaries discharged home between July 2016 and December 2018, researchers found that 34.6% utilized HHC within 30 days. Factors influencing HHC use included age, sex, race, and dual eligibility. While HHC users had lower rates of readmissions and emergency department visits, they experienced slightly higher mortality rates within 30 and 90 days, indicating mixed associations with outcomes and significant variability in HHC utilization across hospitals.
AHRQ-funded; HS027830; HS026003.
Citation: Thompson MP, Hou H, Likosky DS . Home health care use and outcomes after coronary artery bypass grafting among Medicare beneficiaries. Circ Cardiovasc Qual Outcomes 2024 Jul; 17(7):e010459. doi: 10.1161/circoutcomes.123.010459..
Keywords: Home Healthcare, Heart Disease and Health, Cardiovascular Conditions, Medicare, Outcomes
Arbaje AI, Hsu YJ, Keita M
Development and validation of the hospital-to-home-health transition quality (H3TQ) index: a novel measure to engage patients and home health providers in evaluating hospital-to-home care transition quality: a novel measure to engage patients and home...
The objective of this multisite, mixed-methods study was to describe the development, initial psychometric validation, and feasibility of the Hospital-to-Home-Health-Transition Quality (H3TQ) Index to identify patient safety risks. The H3TQ demonstrated feasibility of use, stability, construct validity, and concurrent validity when tested on 75 transitions in five home health care (HH) agencies in rural and urban sites across the U.S. The authors concluded that H3TQ was a novel measure to assess the quality of hospital-to-HH transitions and identify transitions issues, and that their study findings can guide the design of interventions to optimize quality during high-risk hospital-to-HH transitions. They also noted that patients, caregivers, and HH providers offered valuable perspectives and should be included in safety reporting.
AHRQ-funded; HS022916; HS026599.
Citation: Arbaje AI, Hsu YJ, Keita M . Development and validation of the hospital-to-home-health transition quality (H3TQ) index: a novel measure to engage patients and home health providers in evaluating hospital-to-home care transition quality: a novel measure to engage patients and home... Qual Manag Health Care 2024 Jul-Sep; 33(3):140-48. doi: 10.1097/qmh.0000000000000419.
Keywords: Transitions of Care, Patient and Family Engagement, Home Healthcare, Hospital Discharge, Quality of Care
Kirkendall ES, Brady PW, Corathers SD
Safer type 1 diabetes care at home: SEIPS-based process mapping with parents and clinicians.
This study used the Systems Engineering Initiative for Patient Safety (SEIPS) based process mapping method to identify failures and potential solutions associated with medication errors and treatment delays among outpatient children with type 1 diabetes (T1D). A transdisciplinary team of parents, safety researchers, and clinicians used SEIPS based process mapping to collect data on in-home medication review, observation of administration, chart reviews, parent surveys, and failure modes and effects analysis (FMEA). Eight of the 14 children who had home visits experienced 18 errors (31 per 100 medications). Four errors in two children resulted in harm, and 13 errors had the potential for harm. Two injuries occurred when parents failed to treat severe hypoglycemia and lethargy, and two had injuries due to repeated failures to administer insulin at home properly. The SEIPS-based process maps found that high-risk errors occurred during communication between the clinic and home or in management at home. Two FMEAs identified interventions to better communicate with families and support home care.
AHRQ-funded; HS026644.
Citation: Kirkendall ES, Brady PW, Corathers SD . Safer type 1 diabetes care at home: SEIPS-based process mapping with parents and clinicians. Pediatr Qual Saf 2023 May-Jun; 8(3):e649. doi: 10.1097/pq9.0000000000000649..
Keywords: Patient Safety, Diabetes, Home Healthcare, Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Medication, Medical Errors
Arbaje AI, Hsu YJ, Zhou Z
Characterizing changes to older adults' care transition patterns from hospital to home care in the initial year of COVID-19.
A retrospective cohort study examining the impact of COVID-19 on home healthcare (HH) services for older adults in Baltimore and New York City found a 23% decline in HH admissions during the first year of the pandemic. Compared to the prior year, patients receiving HH services during the pandemic were more likely to be younger, have greater medical complexities, and be assessed as having higher rehospitalization risk. Despite this, 30-day rehospitalization rates were lower during the pandemic, particularly for COVID-positive patients. Notably, delays in initiating HH services after discharge were associated with reduced emergency department visits and rehospitalizations in New York City. These findings highlight the pandemic's impact on both the utilization and characteristics of patients receiving HH services, suggesting potential unmet needs among older adults. They emphasize the importance of understanding HH agency responsiveness during public health crises to ensure continued access to care for this vulnerable population.
AHRQ-funded; HS026599.
Citation: Arbaje AI, Hsu YJ, Zhou Z . Characterizing changes to older adults' care transition patterns from hospital to home care in the initial year of COVID-19. J Am Geriatr Soc 2024 Apr; 72(4):1079-87. doi: 10.1111/jgs.18839..
Keywords: Elderly, COVID-19, Transitions of Care, Home Healthcare
Li J
Public reporting and consumer demand in the home health sector.
The author used a natural experiment in the home health sector to assess whether a higher rating under the star ratings program affected patient choice. Findings indicated that higher rated agencies increased their market share by a statistically insignificant amount. No evidence of heterogeneous effects across the rating distribution or over time was discovered. The author concluded that star ratings are unlikely to improve home health quality despite continued policymaker interest.
AHRQ-funded; HS026836.
Citation: Li J . Public reporting and consumer demand in the home health sector. AHRQ-funded; HS026836..
Keywords: Home Healthcare, Nursing Homes, Provider Performance, Patient Experience, Quality of Care
Li J
Home health agencies with high quality of patient care star ratings reduced short-term hospitalization rates and increased days independently at home.
Accurate Medicare Quality of Patient Care home health star ratings are crucial to helping patients find high-quality care, yet critics of these ratings indicate that they are not valid. The purpose of this retrospective study was to assess whether using the highest-rated home health agency available in a ZIP code improves outcomes. The researchers included 1,870,080 Medicare fee-for-service beneficiaries using home health care from July 2015 through July 2016 in the United States. The study found that treatment by the highest-rated agencies available decreased risks of hospitalization, emergency department use, and institutionalization during the initial episode, and increased days independently at home by 2.6% or 3.75 days in the 180 days after the end of the initial episode. Treatment effects were stronger for agencies that were above-average, had 1 or more stars than the next-best agency, and nonrural residents. Effects were positive for both postacute and community-entry patients.
AHRQ-funded; HS026836.
Citation: Li J . Home health agencies with high quality of patient care star ratings reduced short-term hospitalization rates and increased days independently at home. Med Care 2024 Jan; 62(1):11-20. doi: 10.1097/mlr.0000000000001930..
Keywords: Home Healthcare, Quality of Care, Hospitalization, Provider Performance
Scharp D, Hobensack M, Davoudi A
Natural language processing applied to clinical documentation in post-acute care settings: a scoping review.
The purpose of this scoping review was to assess the scope of the application of natural language processing to free-text clinical notes in post-acute care and provide a foundation for future natural language processing-based research in the same settings. The researchers searched PubMed, Cumulative Index of Nursing and Allied Health Literature, and Embase in February 2023. Twenty-one eligible studies. Almost all of which were conducted in home health care settings, had quantitative designs that utilized natural language processing applied to clinical documentation in post-acute care settings. Most studies extracted data from electronic health records to explore the risk for negative outcomes, including acute care utilization, medication errors, and suicide mortality. About half of the studies did not report age, sex, race, or ethnicity data or utilize standardized terminologies. Only 8 studies included variables from socio-behavioral domains. Most studies fulfilled all quality appraisal indicators.
AHRQ-funded; HS027742.
Citation: Scharp D, Hobensack M, Davoudi A . Natural language processing applied to clinical documentation in post-acute care settings: a scoping review. J Am Med Dir Assoc 2024 Jan; 25(1):69-83. doi: 10.1016/j.jamda.2023.09.006..
Keywords: Health Information Technology (HIT), Home Healthcare
Watnick S, Blake PG, Mehrotra R
System-level strategies to improve home dialysis: policy levers and quality initiatives.
This article discusses trends in home dialysis use, reviews the evolving understanding of what constitutes high quality care for the home dialysis population (as well as how this can be measured), and discusses policy and advocacy efforts that continue to shape the care of US patients, and compares with experiences in other countries. The authors conclude by discussing future directions for quality and advocacy efforts.
AHRQ-funded; HS028684.
Citation: Watnick S, Blake PG, Mehrotra R . System-level strategies to improve home dialysis: policy levers and quality initiatives. Clin J Am Soc Nephrol 2023 Dec; 18(12):1616-25. doi: 10.2215/cjn.0000000000000299..
Keywords: Home Healthcare, Kidney Disease and Health, Policy, Quality Improvement, Quality of Care
Keller SC, Hannum SM, Weems K
Implementing and validating a home-infusion central-line-associated bloodstream infection surveillance definition.
Researchers tested the validity of a home-infusion central-line-associated bloodstream infection (CLABSI) surveillance definition and the feasibility and acceptability of its implementation. Their study was conducted in large home-infusion agencies in a CLABSI prevention collaborative in 14 states and the District of Columbia and included semistructured interviews with staff performing home-infusion CLABSI surveillance. The results showed that the home-infusion CLABSI surveillance definition was valid and would be feasible to implement.
AHRQ-funded; HS027819.
Citation: Keller SC, Hannum SM, Weems K . Implementing and validating a home-infusion central-line-associated bloodstream infection surveillance definition. Infect Control Hosp Epidemiol 2023 Nov; 44(11):1748-59. doi: 10.1017/ice.2023.70..
Keywords: Home Healthcare, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs)
Song J, Min SH, Chae S
Uncovering hidden trends: identifying time trajectories in risk factors documented in clinical notes and predicting hospitalizations and emergency department visits during home health care.
The purpose of this study was to characterize risk factor patterns documented in home health care (HHC) clinical notes and explore their relationships with hospitalizations or emergency department (ED) visits. The researchers analyzed data for 73,350 episodes of care from one large HHC organization utilizing dynamic time warping and hierarchical clustering analysis to characterize the patterns of risk factors over time documented in clinical notes. The study found that six temporal clusters emerged, reflecting varying patterns in how risk factors were documented. Patients with a sharp increase in documented risk factors over time had a 3 times greater probability of hospitalization or ED visit than patients with no documented risk factors. The majority of risk factors were found in the physiological domain, and a minority were found in the environmental domain.
AHRQ-funded; HS027742.
Citation: Song J, Min SH, Chae S . Uncovering hidden trends: identifying time trajectories in risk factors documented in clinical notes and predicting hospitalizations and emergency department visits during home health care. J Am Med Inform Assoc 2023 Oct 19; 30(11):1801-10. doi: 10.1093/jamia/ocad101..
Keywords: Emergency Department, Hospitalization, Home Healthcare, Risk
Squires A, Engel P, Ma C
Continuity of care versus language concordance as an intervention to reduce hospital readmissions from home health care.
The purpose of this study was to examine the relative effectiveness of continuity of care and language concordance as alternative or complementary interventions to improve health outcomes of people with limited English proficiency. Participants included over 22,000 non-English-speaking patients from the New York City area who were admitted to their home health site following hospital discharge. Findings revealed that high continuity of care and high language concordance significantly decreased readmissions, along with high continuity of care and low language concordance; low continuity of care and high language concordance did not significantly impact readmissions. The authors concluded that enhancing continuity of care for those with language barriers the US home health system may help to address disparities and reduce hospital readmission rates.
AHRQ-funded; HS023593.
Citation: Squires A, Engel P, Ma C . Continuity of care versus language concordance as an intervention to reduce hospital readmissions from home health care. Med Care 2023 Sep; 61(9):605-10. doi: 10.1097/mlr.0000000000001884..
Keywords: Hospital Readmissions, Transitions of Care, Home Healthcare
Min SH, Song J, Evans L
Home healthcare patients with distinct psychological, cognitive, and behavioral symptom profiles and at-risk subgroup for hospitalization and emergency department visits using latent class analysis.
The purpose of this study was to explore subgroups of older adults receiving home healthcare services with similar psychological, cognitive, and behavioral symptom profiles and an at-risk subgroup for future hospitalization and emergency department visits as an indicator of underdiagnosis or undertreatment. The three-class model applied in the study consisted of Class 1: "Moderate psychological symptoms without behavioral issues," Class 2: "Severe psychological symptoms with behavioral issues," and Class 3: "Mild psychological symptoms without behavioral issues." The study found that Class 1 patients had 1.14 higher odds and Class 2 patients had 1.26 higher odds of being hospitalized or visiting emergency departments compared to Class 3. The researchers discovered significant differences in individual characteristics such as age, gender, race/ethnicity, and insurance.
AHRQ-funded; HS027742.
Citation: Min SH, Song J, Evans L . Home healthcare patients with distinct psychological, cognitive, and behavioral symptom profiles and at-risk subgroup for hospitalization and emergency department visits using latent class analysis. Clin Nurs Res 2023 Sep; 32(7):1021-30. doi: 10.1177/10547738231183026..
Keywords: Home Healthcare, Emergency Department, Hospitalization, Elderly
Oladapo-Shittu O, Hannum SM, Salinas AB
The need to expand the infection prevention workforce in home infusion therapy.
This study looked at the prevalence of formal surveillance and infection prevention training for home infusion staff. The authors interviewed home infusion staff who perform surveillance activities about barriers to and facilitators for central line-associated bloodstream infection (CLABSI) surveillance and identified barriers to training in CLABSI surveillance. Their findings showed a lack of formal surveillance training which can be addressed by by adapting existing training resources to the home infusion setting.
AHRQ-funded; HS027819.
Citation: Oladapo-Shittu O, Hannum SM, Salinas AB . The need to expand the infection prevention workforce in home infusion therapy. Am J Infect Control 2023 May; 51(5):594-96. doi: 10.1016/j.ajic.2022.11.008.AHRQ-funded; HS027819..
Keywords: Healthcare-Associated Infections (HAIs), Prevention, Home Healthcare, Central Line-Associated Bloodstream Infections (CLABSI)
Hobensack M, Song J, Chae S
Capturing concerns about patient deterioration in narrative documentation in home healthcare.
This study aimed to build machine learning algorithms to identify 鈥渃oncerning鈥 narrative notes of home healthcare (HHC) patients and identify emergency themes to support early identification of patients at risk for deterioration. Six algorithms were applied to 4000 narrative notes from a HHC agency to classify notes as either "concerning" or "not concerning." Emerging themes were identified using Latent Dirichlet Allocation bag of words topic modeling. Emerging themes of concern included patient-clinician communication, HHC services provided, gait challenges, mobility concerns, wounds, and caregivers. Most of these themes had already been identified in previous literature as increasing risk for adverse events.
AHRQ-funded; HS027742.
Citation: Hobensack M, Song J, Chae S . Capturing concerns about patient deterioration in narrative documentation in home healthcare. AMIA Annu Symp Proc 2023 Apr 29; 2022:552-59..
Keywords: Home Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT)

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