Reduced Risk of Hospitalization or Emergent Care for Home Care Patients
Renee Nyhof, RN (Holland Hospital Home Health Care); Barbara B. Vincensi, PhD, RN FNP
Hospital admission rates contribute to increased health care costs. These costs are higher at this Midwest suburban hospital compared to the rest of Michigan, and Michigan’s rates are higher than the national average. The use of the M1032, a tool used to look at admission risk factors, may be useful in decreasing admission rates. The purpose of this research was to explore the use of the M1032 in identifying those at risk for emergent care (EC) with or without hospitalization in the home care population. Imogene King’s Goal Attainment Theory was applied because it focuses on how the patient and nurse work together to reach goals, in this case remaining healthy and avoiding hospitalization. A retrospective chart review was done to identify which patients said “yes” to questions regarding core risk factors on the M1032. One-hundred charts were reviewed of home care patients at a facility in western Michigan in September of 2012. Data was analyzed using the SPSS 19.0 statistical software. With the p-value being set at .05 and the confidence interval at 95%, the only significant correlation detected was between risk factor 2 and EC with hospitalization. There was no significant correlation between the number of risk factors and EC with or without hospitalization. The M1032 tool is not useful in identifying those at risk for emergent care with or without hospitalization for Medicare patients admitted to home health care services. Limitations of this study include: data collection from a single home health organization, the M1032 is used for Medicare patients only so there is limited generalizability, and a homogenous sample population. Due to the results of this project, nurses and other healthcare personnel at this agency should investigate what tools are being utilized by other health care agencies to predict the risk for emergent care with or without hospitalization for home health care patients. This will ultimately improve patient health outcomes of hospital admission and healthcare costs overall.
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