Written by Lisa Chedekel
As the Malloy administration seeks to expand home health care options and reduce reliance on nursing homes, a new national report shows Connecticut ranking in the bottom-quarter of states on several key indicators of home health quality, including the percentage of home care patients who show improvement in mobility and who avoid hospitalizations.
Data compiled in the report by the Commonwealth Fund shows that the state’s three hospital referral regions—Hartford, New Haven and Bridgeport—ranked 255th out of 306 regions in 2010-11 in the percentage of home health care patients whose ability to walk or move around improved. The state also was in the lowest quartile nationally for the percentage of home health patients whose wounds healed or improved after an operation.
And Connecticut ranked in the bottom 25 of the 306 regions on the rate of keeping home health patients out of hospitals. The statewide rate of home care patients with a hospital admission was 33.5 percent—meaning one in three Connecticut home health clients landed in the hospital in 2010-11. The national median was significantly lower: 26.6 percent.
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The indicators are recorded by the federal government in an attempt to measure the quality of home health care services provided by licensed agencies across the country.
“Interestingly, many areas in the Northeast—particularly in Connecticut, western Massachusetts and upstate New York—tend to have lower-than-average hospitalization rates among nursing home residents, but have the highest (or worst) rates of hospitalization among persons receiving home health care,” the March report by the Commonwealth Fund says.
Connecticut has a lower-than-average rate of long-stay nursing home residents being admitted to hospitals, according to federal data.
Home health advocates said they are aware that the state’s hospitalization rate is high, and that the mobility improvement rate is low. They said efforts are underway to address those issues, which they attributed to several factors: Connecticut has an older population of home health clients, high rates of hospital readmissions after discharge, and one of the lowest statewide “length-of-stay” rates for hospice care, meaning sicker patients remain in regular home health care.
“People are going back and forth from hospitals to home health care, from home care to hospitals, before they’re getting into hospice care,” said Tracy Wodatch, vice president of clinical and regulatory services for the Connecticut Association for Home Care and Hospice (CAHCH). “With a chronic population, you will see high rates on some of these (quality) measures.”
Gov. Dannel Malloy’s proposed budget expands efforts to move people out of nursing homes and into home-based care, which is generally less expensive. Among the elements of the governor’s proposal are reducing the waiting list for one of the state’s home care waiver programs; retraining some nursing home staff for home care work; and allowing trained, non-licensed home health workers to administer medications to people at home. TO READ THE REST
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