The Costs of Home Health and Patient Outcomes

项目总结/摘要 老年人和慢性病患者越来越多地依赖家庭医疗保健。超过 在过去的十年中，家庭保健机构（HHA）的数量增加了50%以上， 翻了一番。预计这些趋势将继续下去，因为技术使更多的人能够接受护理， 家庭，以及作为付款人和供应商正在寻找成本效益。发展科学并确定 使老年人以具有成本效益的方式最大限度地保持健康和独立的政策是一项 NIA的“老龄化研究的战略方向”的主要主题，以及由 平价医疗法案（ACA）。ACA特别要求CMS更新HH支付系统，以反映 影响成本，健康结果是一个主要因素，并进行研究以建立证据基础 支持这样的更新。这个项目的目的是促进证据基础连接成本和病人的 健康成果。 本项目将通过以下方式调查HH的成本与患者健康结局之间的关系： 成本函数的研究。它将连接主要和次要数据。将进行一项全国性的网络调查， 全国12,000个HHA。该调查将由国家统计局赞助并发出。 家庭护理和临终关怀协会（NAHC）。调查答复将与国家绿洲信息系统和费用挂钩 报告数据，以创建一个独特的数据集，这将允许调查的成本和有效性的具体 改进战略和行动。这项研究将采用先进的经济计量技术， HHA的成本函数。 该项目还提议通过一个 新开发的网上应用程序，使用户能够获得 在用户指定的情况下，改进措施的有效性和成本。该应用程序将基于 在项目的第一部分中估计的关系。 整个项目将受益于NAHC国家咨询小组的支持和建议 由全国保健机构的主任和财务官员组成。 该项目产生的知识将使决策者和人道主义行动者了解 不同类型的机构和市场的成本和患者健康结果之间的关系，并将提供重要的 为旨在激励高效和有效护理的政策提供指导和见解。

PROJECT SUMMARY/ABSTRACT The elderly and those suffering from chronic disease increasingly rely on home health care (HH). Over the last decade, the number of home health agencies (HHAs) has increased by over 50% and expenditures have doubled. These trends are expected to continue as technology allows more individuals to receive care at home, and as payers and providers are looking for cost efficiencies. Developing the science and identifying the policies that will allow the elderly to maximize their health and independence in cost effective ways is a major theme of the NIA's “Strategic Directions for Research on Aging,” and the CMS policy as directed by the Affordable Care Act (ACA). ACA specifically calls for CMS to update the HH payment system to reflect factors influencing costs, health outcomes being a major one, and to undertake studies to develop the evidence base to support such updates. This project is designed to contribute to the evidence base linking costs and patients' health outcomes. This project will investigate the relationship between costs and patient health outcomes in HH through the study of cost functions. It will link primary and secondary data. A national web-based survey will be administered to 12,000 HHAs nationally. The survey will be sponsored and sent out by the National Association of Home Care & Hospice (NAHC). Survey responses will be linked to national OASIS and cost reports data to create a unique dataset, which will allow investigation of the costs and effectiveness of specific improvement strategies and actions. The study will employ sophisticated econometric techniques to estimate cost functions for HHAs. The project is also proposing to disseminate its finding to HHAs, policy makers, and others through a newly developed web-based application that would allow the user to obtain preliminary estimates of effectiveness and costliness of improvement initiatives under user specified scenarios. This app will be based on the relationships estimated in the first part of the project. Throughout, the project will benefit from the support and advice of a NAHC National Advisory Group composed of directors and financial officers of HHAs nationally. The knowledge generated by this project will inform policy makers and HHAs about the relationships between costs and patient health outcomes in different types of agencies and markets and will offer important guidance and insights to policies designed to incentivize efficient and effective care.