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Hospital-to-Home-Health Transition Quality (H3TQ) Index: Further Evidence on its Validity and Recommendations for Implementation.
Arbaje, Alicia I; Hsu, Yea-Jen; Greyson, Sylvan; Gurses, Ayse P; Marsteller, Jill; Bowles, Kathryn H; McDonald, Margaret V; Vergez, Sasha; Harbison, Katie; Hohl, Dawn; Carl, Kimberly; Leff, Bruce.
Afiliación
  • Arbaje AI; Department of Medicine, Division of Geriatric Medicine and Gerontology, Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Hsu YJ; Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
  • Greyson S; Armstrong Institute Center for Health Care Human Factors, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Gurses AP; Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
  • Marsteller J; Department of Medicine, Division of Geriatric Medicine and Gerontology, Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Bowles KH; Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
  • McDonald MV; Armstrong Institute Center for Health Care Human Factors, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Vergez S; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Harbison K; Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
  • Hohl D; Department of Biobehavioral Health Sciences, New Courtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, PA.
  • Carl K; Center for Home Care Policy and Research, VNS Health, New York City, NY.
  • Leff B; Center for Home Care Policy and Research, VNS Health, New York City, NY.
Med Care ; 62(8): 503-510, 2024 Aug 01.
Article en En | MEDLINE | ID: mdl-38967994
ABSTRACT

BACKGROUND:

We developed the Hospital-to-Home-Health Transition Quality (H3TQ) Index for skilled home healthcare (HH) agencies to identify threats to safe, high-quality care transitions in real time.

OBJECTIVE:

Assess the validity of H3TQ in a large sample across diverse communities. RESEARCH

DESIGN:

A survey of recently hospitalized older adults referred for skilled HH services and their HH provider at two large HH agencies in Baltimore, MD, and New York, NY.

SUBJECTS:

There were five hundred eighty-seven participants (309 older adults, 141 informal caregivers, and 137 HH providers). Older adults, caregivers, and HH providers rated 747 unique transitions. Of these, 403 were rated by both the older adult/caregiver and their HH provider, whereas the remaining transitions were rated by either party.

MEASURES:

Construct, concurrent, and predictive validity were assessed via the overall H3TQ rating, correlation with the care transition measure (CTM), and the Medicare Outcome and Assessment Information Set (OASIS).

RESULTS:

Proportion of transitions with quality issues as identified by HH providers and older adults/caregivers, respectively; Baltimore 55%, 35%; NYC 43%, 32%. Older adults/caregivers across sites rated their transitions as higher quality than did providers (P<0.05). H3TQ summed scores showed construct validity with the CTM-3 and concurrent validity with OASIS measures. Summed H3TQ scores were not significantly correlated with 30-day ED visits or rehospitalization.

CONCLUSIONS:

The H3TQ identifies care transition quality issues in real-time and demonstrated construct and concurrent validity, but not predictive validity. Findings demonstrate value in collecting multiple perspectives to evaluate care transition quality. Implementing the H3TQ could help identify transition-quality intervention opportunities for HH patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Servicios de Atención de Salud a Domicilio Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Med Care Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Servicios de Atención de Salud a Domicilio Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Med Care Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos