Homebound older adults: Prevalence, characteristics, health care utilization and quality of care
Homebound older adults: Prevalence, characteristics, health care utilization and quality of care
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DOI：
10.1016/j.gerinurse.2015.06.013
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发表时间：
2015-11-01
影响因子：
2.7
通讯作者：
Yeh, Charlotte S.
中科院分区：
文献类型：
--
作者：
Musich, Shirley;Wang, Shaohung S.;Yeh, Charlotte S.
本研究的目的是评估居家老年人的患病率、他们的特征以及居家状况对医疗服务利用、支出和医疗措施质量的影响。调查问卷发送给AARP(R)Medicare Supplement计划(通过UnitedHealthcare投保)的新参与者(n=25,725)，以筛选严重的慢性病、行动不便和是否有资格参加护理协调计划。卫生保健的利用和支出是根据已支付的索赔确定的。成员级别的质量衡量标准考虑了对药物依从性和护理模式的遵从性。在调查受访者中，19.6%的人被归类为呆在家里。最强烈的预测因素包括严重的记忆力丧失，年龄较大，有更多的慢性病，服用更多的处方药和多次住院。居家医疗服务的使用率和支出明显较高。待在家里的人更有可能不遵守药物依从性和护理模式规则。对归类为居家的新注册者进行持续筛查和后续干预可能是有必要的。(C)2015年提交人。由爱思唯尔公司出版。
The purpose of this study was to estimate prevalence rates of homebound older adults, their characteristics and the impact of homebound status on health care utilization, expenditures and quality of medical care measures. Surveys were sent to new enrollees (n = 25,725) in AARP (R) Medicare Supplement plans (insured through UnitedHealthcare) to screen for serious chronic conditions, ambulatory disabilities and eligibility for care coordination programs. Health care utilization and expenditures were determined from paid claims. Member-level quality measures considered compliance with medication adherence and care patterns. Among survey respondents, 19.6% were classified as being homebound. The strongest predictors of being homebound included serious memory loss, being older, having more chronic conditions, taking more prescription medications and having multiple hospitalizations. Homebound had significantly higher health care utilization and expenditures. Homebound were more likely to be noncompliant with medication adherence and care pattern rules. Ongoing screening and subsequent interventions for new enrollees classified as homebound may be warranted. (C) 2015 The Authors. Published by Elsevier Inc.