Home Health Care Nursing Impacts on Emergency Department Utilization.

Abstract

With health care costs continuing to rise, much attention has been focused on appropriate emergency department (ED) utilization, and nationwide interventions have been developed to support reduction in health care costs and ED use including primary care, community, and home health models. The following is a review of the current state of the evidence regarding patients receiving home health care nursing (HHN) services and impacts on ED utilization. There are significant gaps in the literature regarding the transition from home to ED in patients receiving HHN services; what tools are utilized by home health nurses for triage of patients at home in order to recommend transfer to the ED or other care sources; and what measures are in place for HHN patients regarding variables that are considered to have a higher impact on ED utilization. There is a substantial lack of evidence about whether the effects of HHN services have any relation to, in particular decreasing, ED utilization. There is increasing evidence of the impacts of nurse practitioner care within the community.