Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109532

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:

• At the conclusion of this session, the participant will be able to
• · Identify how both hospital discharge planners and family caregivers define the information needs of patients or their families around home health placement.
• · Describe factors that influence the placement process and the control that both family caregivers and HDPs have over the process.
• · Discuss opportunities for interventions with HDPs that would at once help them with their jobs and help them raise consumers’ awareness of quality and involve them in the decision-making process.

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