VA study shows both higher quality, costs
Study is first of its kind
Research shows that a primary-care based home care system can result in greater patient satisfaction and other benefits, although it may cost more to provide than the traditional model of care for those types of patients.
A randomized, multicenter study funded by the Department of Veterans Affairs (VA) Health Services Research and Development and the VA Cooperative Studies Program of Washington, DC, has found some significant benefits to patients receiving home care services by physicians, nurse practitioners, and other disciplines. The drawback might be the cost, which at the VA study found to be higher over a 12-month period.
Patient satisfaction higher
Here are some of the study’s results:
• Patients assigned to the VA’s home-based primary care team cost an average of $31,401 over a 12-month period; patients receiving customary care and assigned to the control group cost an average of $28,008 in the same period.1
• The primary care group had 9.3 rehospitalizations on average over the first six months, while the control group had 9.5 rehospitalizations in the same period.1
• Over a 12-month period, the primary care group had an average of 14.7 hospitalizations, compared with 13.3 for the control group.1
• Patients in both groups had a mean of 3.2 activities of daily living impairments, most commonly involving bathing, dressing, and transferring. Four out of five of the patients lived with a family caregiver, and most of the patients were at medium-to-high risk of rehospitalization.1
• Researchers assessed patient and caregiver satisfaction by using the Barthel Index. Their quality of life was assessed through the Medical Outcomes Study, Short Form-36.1
• Both terminally ill patients and nonterminally ill patients in the primary care group had a significant improvement in their health-related quality of life when compared with the control group.1
• Nonterminal patients in the primary care group reported a significantly higher satisfaction with care.1
• Caregiver ratings of satisfaction also were higher among the primary care group.1
• The trial spanned four years at 16 hospitals across the United States.
Reference
1. Hughes SL, Weaver FM, Giobbie-Hurder A, et al. Effectiveness of team-managed home-based primary care: A randomized multicenter trial. JAMA 2000; 284:2,877-2,885.
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