204862 Red alert rates and follow-up rates per 60-day episode of home care

Tuesday, November 10, 2009

Amanda L. Golbeck, PhD , School of Public and Community Health Sciences, University of Montana, Missoula, MT
Julie Pinsonneault, RN , Partners in Home Care, Inc., Missoula, MT
Dianne Hansen, BA, MT, COS-C , Partners in Home Care, Inc., Missoula, MT
The objective of this home health care study was to develop additional quantitative measures for documenting access to health care with tele-monitoring. Access has typically been measured by using numbers of patients who have tele-monitoring equipment placed in their homes; increases in these numbers are used to indicate increases in access to health care. We propose that access also be measured by rates of red alerts, and rates of follow-ups to red alerts, per 60-days of care. Tele-monitored patients used equipment to take their vital signs and transmit readings to a central station, where a trained nurse reviewed the readings, noted the red alerts, and determined whether there should be a follow-up action. Red alerts were generally indicated when readings fell outside of a range predetermined by health care providers for the individual patient. Follow-ups were with patients/caregivers, nurse care managers, or physicians. An episode of care, following Medicare payment protocols for home care services, may continue for a 60 day period of time. We present definitions of red alert, and follow-up, rates. We illustrate use of these rates with underserved rural and tribal homebound patients in three sparsely populated Montana counties. These measures document the rates at which rural homebound patients had abnormal physiological response to disease detectable by vital signs and thus were at increased risk of medical problems; as well as the rates at which the central station nurse subsequently followed up to mitigate these increased risks.

Learning Objectives:
1. Explain how period rates in demography may be adapted for use in home health care studies. 2. Formulate rates of vital sign abnormalities, and of follow-ups with patients or providers, per 60-day episode of care. 3. Describe the use of red alert rates and follow-up rates in documenting increased access to care among home bound patients.

Keywords: Telehealth, Access to Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I earned a PhD in Biostatistics from the University of California at Berkeley. I have been a academician and consulting biostatistician for over twenty five years. I am currently the consulting statistician on a HRSA funded Tele-home Care study. The content of our poster is from this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Statistics Section Poster Session
See more of: Statistics