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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
5108.0: Wednesday, December 14, 2005 - 12:54 PM

Abstract #109532

Challenges of communicating with consumers about home health care via information intermediaries: Key findings from formative and exploratory research

Margaret Gerteis, PhD1, Sally Crelia, MPH2, Jessie Gerteis3, Lauren Blatt2, Andrew Maxfield, PhD2, Erika Melman2, Alyson E. M. Ward, MPH2, Beth Simon, PhD4, Christopher Koepke, PhD5, William Lehrman, PhD4, Rosemary Lee, RN4, and Elizabeth Goldstein, PhD4. (1) Health Department, Mathematica Policy Research, 955 Massachusetts Avenue, Suite 801, Cambridge, MA 02139, 617 491-7900, ext 280, mgerteis@comcast.net, (2) Health Services Research & Management Group, BearingPoint, 1676 International Drive, McLean, VA 22102-4828, (3) Boston Medical Center, One Boston Medical Center Place, Boston, MA 02118, (4) Centers for Medicare & Medicaid Services, 7500 Security Blvd, Baltimore, MD 21244, (5) Center for Beneficiary Choices, Centers for Medicare & Medicaid Services, 7500 Security Blvd., Mailstop S1-15-03, Baltimore, MD 21244-1850

Objective: To investigate the role of hospital discharge planners (HDPs) as information intermediaries for Medicare beneficiaries and family caregivers, and explore informational tools to facilitate communication about home health care. Methods: Focus groups (17), dyads (8), and passive participant observation (9 sites) in multiple markets, with hospital-based nurses, social workers, and case managers with primary responsibility for arranging post-hospital home health care for Medicare beneficiaries; focus groups (2) and one-on-one in-depth interviews (37) with Medicare beneficiaries and family caregivers in multiple markets who have prior home health care experience. Results: Beneficiaries and family caregivers understand little about home health care at the time of post-hospital placement and rely almost entirely on HDPs for information. Most HDPs know they are required to offer patients or families a choice of home health agencies, and almost all provide a list from which to choose. However, HDPs were largely unaware of Medicare sources of information and feared that discussing quality with patients or families would complicate or “bias” the referral process. However, HDPs welcomed simple informational tools that would explain the Medicare home health benefit. Conclusions: HDPs are critical to the process of communicating with consumers about home health care, but they resist engaging patients or family caregivers actively in discussions about the relative merits of placement options. Findings suggest the need to get buy-in from HDPs in order to reach patients with home health care information. Strategies that address the perceived informational needs of both HDPs and family caregivers may thus be preferred.

Learning Objectives:

Keywords: Home Care, Quality of Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commertial supporters WITH THE EXCEPTION OF I am employed by a private research and consulting firm that does contract work for agencies of the federal government..

[ Recorded presentation ] Recorded presentation

Consumer Research and Medicare: Meeting the Challenge to Communicate with 42 Million People

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA