Home Health Care Management Research Articles

Project Management: A Powerful Approach for Home Health Care Management

This article stresses the potential application of a formal project management approach to home health care management. Following a brief description of project management, implementation factors are discussed to facilitate the successful implementation of this approach and to reap the expected benefits. A sample of project management techniques and tools are described, especially for the planning and controlling of projects typically used in the home health care field. Managers can readily see that adopting project management can be done with minimal organizational disruption and training. Clearly, the costs of adopting project management are relatively small compared with the potential benefits in terms of improved efficiency and productivity, work quality, reduced work stress, and reduced conflict at the interpersonal and organizational levels.

Home Health Care Management

Home Health Care Management

Case Management and Home Health Care: An Integrated Model

This article presents a model of integration of home health care and case management programs, designed to improve outcomes and reduce cost. Components of screening mechanisms, interventions, and outcomes are described. Financial methods for funding such a model are discussed as well as how to position and market this type of program to managed care organizations. Preliminary results of such a program implemented in a staff model HMO demonstrate reduced beddays, increased memberlphysician satisfaction, high quality outcomes, and cost effectiveness.

Transforming Nursing Practice: Acute to Community Care

This article describes the collaborative project among an educational institution, acute care hospitals, and home health agencies that led to further defining roles and ensuring employment for the region's professional nurses. The redistribution of care from the hospital to the community creates a demand for expanded skill and knowledge among nursing in community practice. Yet experienced hospital acute care nurses are finding that they have a lack of expanded skills required in community-based nursing. Home health care managers find that acute nurses require an extensive and costly orientation process to community health nursing. From this article the reader will examine the environmental factors affecting the delivery of quality home health care in the late 1990s; the knowledge and skills required for the transition from acute to community care; and a proposed collaborative program design that meets home health administrators' needs to maintain a highly skilled staff.

Access to home health care: Negotiating with the gatekeepers

This article focuses on the increasing need to assist the client to access the home health care system. The "gatekeepers," or those controlling the referrals, are varied and growing in number. The need to educate has never been as critical as it is in the current health care environment. This article presents the steps necessary to negotiate for services on behalf of the client. This is necessary reading for all clinicians, discharge planners, home care intake coordinators, home health care managers, and other gatekeepers.

Private Health Insurance of Chronically III Children

Accurate information regarding the adequacy of private health insurance coverage available to the families of chronically ill children is scarce. A national survey was conducted of firms offering health insurance to employees and their dependents. Data were collected concerning private health insurance coverage of services needed by chronically ill children, including basic medical care services, ancillary therapies, mental health services, and long-term care. Nearly all surveyed firms offered health insurance. Coverage of inpatient hospital care, outpatient physician services, medical supplies and equipment, x-ra y stuies, laboratory services, and prescription medications was widespread, but coverage of services such as physical therapy, speech therapy, occupational therapy, and nutrition services was much less prevalent. More than two thirds of the firms covered comprehensive home health services but often with limits and only in lieu of more expensive inpatient care. Longterm care, such as skilled nursing home care, was covered by only one third of firms. Overall, the survey results, combined with information concerning recent trends in private health insurance, reveal increasing coverage of lower cost alternatives to hospital or institutional care and improved maximum lifetime benefits and stop-loss coverage but also increased cost-sharing requirements. These results suggest that, although families with chronically ill children may have access to a widening range of services such as home health care or individual benefits management, they may be forced to bear an increasing proportion of the cost.

A look at catastrophic medical expenses and the poor.

A look at catastrophic medical expenses and the poor.

Epidemiology of dysphoria and depression in an elderly population.

The authors surveyed 997 elderly people living in the community and found that the rate of significant dysphoric symptomatology was 14.7%. Forty-five (4.5%) of these individuals suffered from dysphoric symptoms only, and 37 (3.7%) had symptoms of a major depressive disorder. Eighteen (1.8%) suffered from symptoms of primary depressive disorder and 19 (1.9%) from symptoms of secondary depressive disorder. Sixty-five (6.5%) had depressive symptoms associated with impaired physical health. The frequency of widowhood, impairment in social resources, and impairment in economic resources was greater for individuals with symptoms of a major depressive disorder. The entire sample used psychiatric services at a very low rate.