Predictors of Hospitalization Among Home Health Managed Care Patients

Objectives: To identify variables associated with hospitalization among managed care patients enrolled in home health services. Design: Retrospective analysis using Home Health Outcome and Assessment Information Set (OASIS) and home health visit data. Setting: Three managed care agencies. Participants: Sixty-five and above, Medicare patients admitted between March 1, 2007 and February 29, 2008. Measurements: Home health care episodes were defined as the time from admission to hospitalization or discharge. Cox regression analyses were conducted to determine predictors of hospitalization. Results: The analysis included 6,805 episodes. Predictors of hospitalization included being male or African American, living in a board and care facility, and having therapies at home, among others. Nurse visits were associated with increased hospitalization whereas social worker visits were associated with decreased hospitalization. Conclusion: This study provides implications for improving clinical practice. Knowing factors associated with hospital admission, home health staff can identify potential risks and develop targeted care plans that may reduce avoidable hospital admission rates.