Departments of Health Policy and Management.
Biostatistics, Johns Hopkins Bloomberg School of Public Health.
Med Care. 2021 Apr 1;59(4):341-347. doi: 10.1097/MLR.0000000000001487.
Medicare home health providers are now required to deliver family caregiver training, but potential consequences for service intensity are unknown.
The objective of this study was to assess how family caregiver training needs affect the number and type of home health visits received.
Observational study using linked National Health and Aging Trends Study (NHATS), Outcomes and Assessment Information Set (OASIS), and Medicare claims data. Propensity score adjusted, multivariable logistic, and negative binomial regressions model the relationship between caregivers' training needs and number/type of home health visits.
A total of 1217 (weighted n=5,870,905) National Health and Aging Trends Study participants receiving Medicare-funded home health between 2011 and 2016.
Number and type of home health visits, from Medicare claims. Family caregivers' training needs, from home health clinician reports.
Receipt of nursing visits was more likely when family caregivers had medication management [adjusted odds ratio (aOR): 3.03; 95% confidence interval (CI): 1.06, 8.68] or household chore training needs (aOR: 3.38; 95% CI: 1.33, 8.59). Receipt of therapy visits was more likely when caregivers had self-care training needs (aOR: 1.70; 95% CI: 1.01, 2.86). Receipt of aide visits was more likely when caregivers had household chore (aOR: 3.54; 95% CI: 1.82, 6.92) or self-care training needs (aOR: 2.12; 95% CI: 1.11, 4.05). Medication management training needs were associated with receiving an additional 1.06 (95% CI: 0.11, 2.01) nursing visits, and household chores training needs were associated with an additional 3.24 total (95% CI: 0.21, 6.28) and 1.32 aide visits (95% CI: 0.36, 2.27).
Family caregivers' activity-specific training needs may affect home health visit utilization.
医疗保险家庭保健服务提供者现在需要提供家庭护理人员培训，但服务强度的潜在后果尚不清楚。
本研究旨在评估家庭护理人员培训需求如何影响家庭保健访问的数量和类型。
使用国家健康老龄化趋势研究（NHATS）、结果和评估信息集（OASIS）和医疗保险索赔数据进行观察性研究。倾向评分调整的多变量逻辑回归和负二项回归模型用于评估护理人员培训需求与家庭保健访问数量/类型之间的关系。
共有 1217 名（加权 n=5870905）接受 2011 年至 2016 年医疗保险资助的家庭保健的国家健康老龄化趋势研究参与者。
来自医疗保险索赔的家庭保健访问次数和类型。家庭护理人员的培训需求，来自家庭保健临床医生的报告。
当家庭护理人员有药物管理[调整后的优势比（aOR）：3.03；95%置信区间（CI）：1.06，8.68]或家务培训需求（aOR：3.38；95%CI：1.33，8.59）时，更有可能接受护理访问。当护理人员有自我护理培训需求时，接受治疗访问的可能性更高（aOR：1.70；95%CI：1.01，2.86）。当护理人员有家务[ aOR：3.54；95% CI：1.82，6.92]或自我护理培训需求时，更有可能接受助手访问（aOR：2.12；95% CI：1.11，4.05）。药物管理培训需求与接受额外的 1.06 次（95%CI：0.11，2.01）护理访问相关，家务培训需求与额外的 3.24 次（95%CI：0.21，6.28）和 1.32 次助手访问（95%CI：0.36，2.27）相关。
家庭护理人员特定活动的培训需求可能会影响家庭保健访问的使用。
