People Who Refuse Home Health More Likely to Return to Hospital
May 17, 2017 02:14 PM
People who decline home health care services after being discharged from the hospital are far more likely to be re-admitted to the hospital than people who use home health services, according to a recent report from the United Hospital Fund (UHF).
The report, “I Can Take Care of Myself! Patients’ Refusals of Home Health Care Services,” found that 28 percent of 495 eligible patients surveyed refused home health care and those who did refuse were twice as likely as those who accepted to be re-admitted to the hospital within 30 or 60 days of discharge. Patients who accepted home health generally reported better quality of life in the weeks and months following discharge from the hospital.
Reasons patients gave for refusing home health care services focused mainly on financial concerns, a belief that their family could provide the necessary care, and fear of losing privacy and/or control over their lives. “Home health care may be considered by some as an unwelcome reminder of illness, frailty and loss of independence,” according to the report.
“As medical care increasingly moves from hospitals into the community, which for most people means care at home, the importance of home health care services in discharge planning is growing in importance,” said Carol Levine, director of UHF’s Families and Health Care Project and one of the authors of the report. “But there is little guidance for hospital staff on what to do when eligible patients refuse home health care.”
The report cites various problems leading some patients to refuse home health services, such as inflexible criteria for eligibility, inadequate payment for home health agencies services for patients with complex conditions and shortages of trained home health caregivers.
While patients sometimes don’t understand the benefits of home health services, they are not the only ones battling ignorance on this issue. Family caregivers sometimes make the decisions for patients and may also be unaware of the home health benefit and the enormous good it can do for patients.
The report notes that continuity of care would improve with coordinated hospital discharge planning, with home health care a crucial part of the standardized policy.
The report also recommends policy changes to increase access to home health services, more research on all aspects of home health care refusals, and greater education about post-discharge health issues and home health care services.