Refusing Home Health Increases Chances of Returning to Hospital

Posted on Thursday, May 18, 2017 3:49 PM

According to a recent report from the United Hospital Fund (UHF), people who decline home health care services after being discharged from the hospital are far more likely to be re-admitted to the hospital than people who use home health services.

The report, “I Can Take Care of Myself! Patients’ Refusals of Home Health Care Services,” results found that 28 percent of 495 eligible patients surveyed refused home health care. In addition, those who refused home health care were twice as likely as to be re-admitted to the hospital within 30 or 60 days of discharge. Following discharge from the hospital, the patients who accepted home health reported better quality of life in the weeks and months.

The following reasons as to why patients refused health care services include:
• Financial concerns
• Belief that their family could provide the necessary care
• Fear of losing privacy and/or control over their lives

“Home health care may be considered by some as an unwelcome reminder of illness, frailty and loss of independence,” according to the report.

“As medical care increasingly moves from hospitals into the community, which for most people means care at home, the importance of home health care services in discharge planning is growing in importance,” said Carol Levine, director of UHF’s Families and Health Care Project and one of the authors of the report. “But there is little guidance for hospital staff on what to do when eligible patients refuse home health care.”

The report notes the following problems that lead to patients refusing home health services:
• Inflexible criteria for eligibility
• Inadequate payment for home health agencies services for patients with complex conditions
• Shortages of trained home health caregivers

In addition, family caregivers tend to make the decisions for patients and aren’t aware that of the home health benefits.

The report recommends the following:
• Policy changes to increase access to home health services
• Research all aspects of home health care refusals
• Increased education about post-discharge health issues and home health care services

For the full article, click here.

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