Changes in home health care delivery.

The Taylor hypothesis suggests that the effect of DRGs is an episodic increase in referrals to home health care agencies of both chronically ill and acutely ill patients. These patients will need to recuperate from the acute illness that caused their hospitalization in the first place. The New Jersey experience indicates that the tightening reimbursement system will permit a shorter episode of home care services than in the past few years. Agencies will have to provide seven-day, twenty-four-hour service. At the same time, they will have more difficulty justifying seven-day intervention to the Medicare program. Understanding the full effects of the change in health care delivery reimbursement on patient care and nursing care will require research and investigation.