Date of Award
Spring 4-2-2024
Embargo Period
12-31-2024
Document Type
Dissertation - MUSC Only
Degree Name
Doctor of Philosophy (PhD) in Health & Rehabilitation Science
College
College of Health Professions
First Advisor
Kit Simpson
Second Advisor
Sara Knox
Third Advisor
Daniel Brinton
Fourth Advisor
Corey Morrow
Abstract
Not all survivors of acute ischemic stroke (AIS) discharged home after hospitalization with a HH referral receive HH and some survivors discharged home to self-care receive HH. Broad population level HH utilization pattern studies are needed to assure optimal access to HH.
Three retrospective observational cohort studies describe HH referral patterns, use, and cost, comparing those discharged home to self-care vs. discharged home with a HH referral. Thirty day hospital readmission rate, demographics, and diagnoses for a subset of 251 survivors are described.
Survivors who were older, female, Medicaid eligible, or had a greater comorbidity burden were more likely to receive a HH referral. A subset with HH and a HH referral received HH sooner, had a more complex inpatient stay, and a more severe stroke than those discharged home to self-care. Those with severe strokes referred home to self-care had 5 more HH visits. Hospital readmission rate was 21.9%, averaging $14,046. Approximately half were readmitted prior to receiving HH, 73.3% for recurrent stroke or stroke-related complications.
These results show a need to examine referral practices to identify opportunities to improve fit between HH referral and HH use and support future study of hospital discharge and community follow up processes.
Recommended Citation
Van Kirk, Suzanne, "Home Health Utilization and Health Outcomes for Medicare Fee for Service Survivors of Acute Ischemic Stroke" (2024). MUSC Theses and Dissertations. 863.
https://medica-musc.researchcommons.org/theses/863
Rights
Copyright is held by the author. All rights reserved.