Formal Home Health Care Services and the Likelihood of Hospital Inpatient Admissions
Comfort, Leeann N.
Using a linear probability model and a fixed effect model, this study finds that the provision of formal home health services in a given month is associated with an increase in the probability of experiencing an inpatient admission during the same month by as much as ten percentage points. Although the short term effect of home health services are strongly positive, the longer term effect demonstrated by the provision of formal home health services in the previous month is associated with a 7.4 percentage point decline in the likelihood of experiencing an inpatient admission. As such, the cumulative influence of receiving home health services in the previous and current months is associated with an increase of only three percentage points in the likelihood of hospitalization. The difference between the short term and long term relationships of formal home health care and the likelihood of hospitalizations is illustrative of the different influences of its preventive qualities, which are associated with a decreased probability of hospitalization, and monitoring qualities, which are associated with increased probabilities of inpatient admission when an individual is being monitored by a health care professional. Similar analyses on hospitalizations originating from the emergency department confirm the directions of the short term and long term correlations between formal health care and hospitalizations, though formal home health care is associated with changes in emergency department-originating hospitalizations of about half magnitude as the changes seen in all hospitalizations. Despite the strongly significant results for the independent variables of interest, the analysis lacks the precision necessary to investigate the specific relationship between formal home health care and hospitalizations attributable to conditions that can be treated, managed, or prevented with formal home health care. Nor do the results of the study offer insight into whether the increased probability of hospitalizations is a desirable outcome, as an increased probability of hospitalization while receiving home health care could be associated with either unnecessary admissions or more timely identification of emergent health issues. However, the substantively and statistically significant results of the study do indicate promise for further inquiry into the topic.
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