This study identified the process and agency characteristics associated with poor utilization outcomes - higher percentages of patients ( i ) admitted to an acute care organization and ( ii ) visited an emergency room (ER) unplanned without hospitalization - for home health agencies (HHAs) in the United States. We conducted a secondary analysis of data about HHAs' various characteristics, process adherence levels, and utilization outcomes collected from disparate public repositories for 2010-2022. We developed descriptive tree-based models using HHAs' hospital admission or ER visit percentages as response variables. Across the board, hospital admission percentages have steadily improved while ER percentages deteriorated for an extended period. Recently, checking for fall risks and depression was associated with improved outcomes for urban agencies. In general, rural HHAs had worse utilization outcomes than urban HHAs. Targeted investments and improvement initiatives can help rural HHAs close the urban-rural gap in the future.
Keyphrases
- healthcare
- acute care
- emergency department
- public health
- south africa
- end stage renal disease
- depressive symptoms
- chronic kidney disease
- newly diagnosed
- type diabetes
- ejection fraction
- metabolic syndrome
- prognostic factors
- big data
- machine learning
- physical activity
- endoplasmic reticulum
- health information
- electronic health record
- patient reported outcomes