The Costs of Home Health and Patient Outcomes

项目摘要/摘要 老年人和慢性病患者越来越依赖家庭保健(HH)。完毕 在过去的十年中，家庭保健机构(Hha)的数量增加了50%以上，支出 翻了一番。这些趋势预计将继续下去，因为技术允许更多的人在 因为付款人和提供者都在寻找成本效益。发展科学和识别 允许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 NIA“老龄化研究战略方向”的主要主题，以及由NIA指导的CMS政策 《平价医疗法案》(ACA)。ACA特别呼吁CMS更新HH支付系统以反映因素 影响成本，健康结果是一个主要因素，并进行研究以发展证据基础 以支持此类更新。该项目旨在为证据基础做出贡献，将费用和患者的 健康结果。 该项目将通过以下方式调查HH的费用和患者健康结果之间的关系 对成本函数的研究。它将把主要数据和次要数据联系起来。一项基于网络的全国性调查将是 在全国范围内向12,000名HHAS实施。这项调查将由国家统计局赞助并发出 家庭护理与临终关怀协会(NAHC)。调查答复将与国家绿洲和成本挂钩 报告数据以创建唯一的数据集，从而可以调查特定项目的成本和有效性 改进策略和行动。这项研究将使用复杂的计量经济学技术来估计 HHA的成本函数。 该项目还提议将其发现通过一个 新开发的基于网络的应用程序，允许用户获得初步估计 在用户指定的场景下改进计划的有效性和成本。此应用程序将基于 关于项目第一部分中估计的关系。 在整个过程中，该项目将受益于NAHC国家咨询小组的支持和建议 由他在全国范围内的董事和财务人员组成。 此项目所产生的知识将向政策制定者和HHA通报 在不同类型的机构和市场中的成本和患者健康结果之间的关系，并将提供重要的 对旨在激励高效和有效护理的政策的指导和见解。

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.