OASIS Alert

Quality Improvement:

National Campaign Results Don't Show Up On Home Health Compare

Use the data to check your local agencies.

Three Home Health Compare measures show improvement this quarter -- but three stubbornly refuse to budge.

The updated Home Health Compare data posted in June show a continuing upward trend. Seven of the 10 publicly reported measures have improved in the last year. Three have gone up one percentage point and four have increased two percentage points -- including the three new winners:

  • Patients who get better at bathing improved from 63 to 64 percent. This outcome measure stood at 57 percent when Home Health Compare debuted in November 2003.
  • Patients who get better at taking oral medications rose from 41 to 42 percent over the three-month period, after starting at 35 percent in 2003.
  • Patients who are short of breath less often went from 60 to 61 percent. The original Home Health Compare publicly reported data did not contain this outcome, but it was at 58 percent when it was first included in September 2005.

No Measurable Improvement

The only three Home Health Compare outcome measures that have shown no im-provement this year are:

  • Patients who stay at home after a home health episode ends, which remains at 68 percent nearly two years after this outcome was added to the report.
  • Patients who had to be admitted to the hospital, which is still at the 28 percent mark where it started in November 2003.
  • Patients who need urgent unplanned medical care, also unchanged since its 2003 debut at 21 percent.

Challenge: State and regional differences continue to work against being able to see improvement in these measures, says clinical consultant Judy Adams with Charlotte, NC-based LarsonAllen. For example, for the December 2006 Home Health Compare, 11 of the 51 states improved their acute care hospitalization rate by 1 percentage point, while the remainder stayed the same or scored worse, she notes. This resulted in the national average staying the same.

In addition, clear regional differences exist, with significantly better scores on hospitalization in the northwest, mountain and western regions than in the northeast, southeast, central, midwest and southwest regions, Adams reports. But agencies can still use publicly reported data to compare their agency's results with those of their competitors, experts say.

Data Lag Postpones Viewing ,Results

August is the one-year anniversary of the Centers for Medicare & Medicaid Services' intense nationwide initiative to reduce acute care hospitalization and emergent care, but Home Health Compare data will take awhile longer to show the results, experts predict.

Stay tuned: Keep in mind that Home Health Compare data is historical and does not reflect current results from agencies' efforts, Adams says. Data reported in June 2007 covered the period from January 2006 through December 2006. So some of it is well over a year old.

Note: For more information about the Home Health Quality Improvement National Campaign, go to www.homehealthquality.org.

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