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Exploratory analysis of the relationship between home health agency engagement in a national campaign and reduction in acute care hospitalization in US home care patients
Author(s) -
Esslinger E. Eve,
Schade Charles P.,
Sun Cynthia K.,
Sun Ying Hua,
Manna Jill,
Hall Bethany Knowles,
Wright Shanen,
Hannah Karen L.,
Lynch Janet R.
Publication year - 2014
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12198
Subject(s) - exploratory analysis , medicine , quartile , agency (philosophy) , intervention (counseling) , gerontology , nursing , family medicine , psychology , computer science , confidence interval , philosophy , data science , epistemology
Abstract Rationale, aims and objectives To determine whether US home health agencies that intensively engaged with the 2010 H ome H ealth Q uality I mprovement N ational C ampaign were more likely to reduce acute care hospitalization ( ACH ) rates than less engaged agencies. Method We included all M edicare‐certified agencies that accessed C ampaign resources in the first month of the C ampaign and also responded to an online survey of resource utilization at month two. We used the survey data and item response theory to estimate a latent construct we called engagement with the campaign. ACH rates were calculated from the C enters for M edicare & M edicaid S ervices O utcome and A ssessment I nformation S et for pre‐ and post‐intervention periods ( M arch– N ovember 2009 and 2010, respectively). Results Staff from 1077 agencies accessed resources in the first month of the C ampaign. Of these, 382 provided information about resource use and had 10 or more monthly discharges throughout the measurement periods. Dividing these agencies into quartiles based on engagement score, we found an association between engagement and reduction in ACH rates, P = 0.049 (χ 2 for trend). Exploratory path analysis revealed the effect of engagement score on reduction in ACH rate to be partially mediated through reduction in average length of service rates. Conclusion We found evidence that early intensity of engagement with the C ampaign, as measured through use of activities and resources, was positively associated with improvement. To continue the investigation of this relationship, future work in this and other campaigns should focus on further development of engagement measures.