The availability of Outcome and Assessment Information Set (OASIS) data enables investigations of functional status changes over Medicare home care episodes. Objective: Determine how functional status changes are predicted by predisposing, enabling, and need variables. Methods: Patients (n=1,182) were 65+ years old with completed episodes of Medicare-funded home care from 3 Connecticut agencies between March 1999 and April 2000. OASIS data were used to measure independent variables: age group, gender, ethnic group (predisposing); frequency of informal support and type of Medicare insurance (enabling); source of admission to home care, rehabilitation prognosis by home care staff, and functional status (need). Functional status was measured by summing 8 personal care activities of daily living (ADL; score range=0-33) and 7 instrumental ADL (IADL; score range=0-20). Dependent variables were built by subtracting discharge from start of care ADL and IADL scores; multiple regression models were run for each dependent variable. Results: More patients were female (62%), 91% were White, with mean age=79+/-7. On average, ADL change (mean=2.2+/-3.9), and IADL change (mean=2.3+/-3.5)was slight. Statistically significant (p< .01) predictors of ADL improvement were: good rehabilitation prognosis, admission from hospital, greater ADL dependence at start of care, and younger age (model R2=.25). Predictors of IADL improvement were identical, substituting greater IADL dependence at start of care (model R2=.16). Conclusions: Dramatic changes in function were not seen in Medicare home care patients. Those more likely to improve were younger, admitted to home care from hospitals, given a good rehabilitation prognosis, and more functionally dependent at the start of care.
Learning Objectives: Explain how function-based outcome measures can be constructed using OASIS data. Identify predictors of functional status change in Medicare home care users.
Keywords: Home Care,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.