Objective
To examine the association of family members' perception about the adequacy of home
health services at the last place of care before death.
Design
Retrospective cross-sectional study. Mortality follow-back survey by telephone interview.
Setting
Home health services.
Participants
Bereaved family members or knowledgeable informants of deceased persons in 22 states.
Measurements
Proxy perception of need of home health care during the last 12 months of decedent's
life, whether the amount of care received was enough, and last place of care (ie,
where the person spent at least 48 hours nearest to the time of death).
Results
Of the 1578 interviews, 622 informants reported that decedents needed home health
care in the last year of life. Among decedents needing home health care, 144 informants
reported that the home health services provided did not meet their needs. After adjusting
for age, gender, insurance, education, race, cause of death, functional status, and
place of residence, decedents reported as not receiving enough home health care were
1.8 (95% CI 1.1–2.9) times more likely to die in a nursing home.
Conclusion
The perception that home health services before death did not meet the decedent's
needs may contribute to greater nursing home use.
Keywords
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Article info
Publication history
Published online: November 26, 2009
Footnotes
The authors have no conflicts of interest regarding this article.
Funding for this research was provided by the Robert Wood Johnson Foundation (Grant #037188). The opinions and findings in this manuscript are those of the authors and do not necessarily represent the views of Robert Wood Johnson Foundation. The Robert Wood Johnson Foundation did not have any role in the design, conduct or interpretation of the research or in the review, approval, or control of the manuscript.
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© 2010 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.
