Home Health Care Utilization in Children With Medicaid

被引:8
作者
Sobotka, Sarah A. [1 ,5 ]
Hall, David E. [2 ]
Thurm, Cary [3 ]
Gay, James [2 ]
Berry, Jay G. [4 ]
机构
[1] Univ Chicago, Dept Pediat, Sect Dev & Behav Pediat, Chicago, IL USA
[2] Vanderbilt Univ, Monroe Carell Jr Childrens Hosp Vanderbilt, Sch Med, Dept Pediat, Nashville, TN USA
[3] Childrens Hosp Assoc, Lenexa, KS USA
[4] Harvard Med Sch, Boston Childrens Hosp, Dept Pediat, Div Gen Pediat, Complex Care Serv, Boston, MA USA
[5] Univ Chicago, Dept Pediat, Sect Dev & Behav Pediat, Chicago 950 E 61st St,Suite 207, Chicago, IL 60637 USA
基金
美国国家卫生研究院;
关键词
LONG-TERM-CARE; SERVICES; NEEDS; COMPLEXITY; FAMILIES; EXPERIENCES; CAREGIVERS; OUTCOMES; IMPACT; POLICY;
D O I
10.1542/peds.2021-050534
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
BACKGROUNDAlthough many children with medical complexity (CMC) use home health care (HHC), little is known about all pediatric HHC utilizers. Our objective was to assess characteristics of pediatric HHC recipients, providers, and payments. METHODSWe conducted a retrospective analysis of 5 209 525 children age 0-to-17 years enrolled Medicaid in the 2016 IBM Watson MarketScan Medicaid Database. HHC utilizers had >= 1 HHC claim. Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) codes were reviewed to codify provider types when possible: registered nurse (RN), licensed practical nurse (LPN), home health aide (HHA), certified nursing assistant (CNA), or companion/personal attendant. Enrollee clinical characteristics, HHC provider type, and payments were assessed. Chronic conditions were evaluated with Agency for Healthcare Research and Quality's Chronic Condition Indicators and Feudtner's Complex Chronic Conditions. RESULTSOf the 0.8% of children who used HHC, 43.8% were age <1 year, 25% had no chronic condition, 38.6% had a noncomplex chronic condition, 21.5% had a complex chronic condition without technology assistance, and 15.5% had technology assistance (eg, tracheostomy). HHC for children with technology assistance accounted for 72.6% of all HHC spending. Forty-five percent of HHC utilizers received RN/LPN-level care, 7.9% companion/personal attendant care, 5.9% HHA/CNA-level care, and 36% received care from an unspecified provider. For children with technology assistance, the majority (77.2%) received RN/LPN care, 17.5% companion/personal assistant care, and 13.8% HHA/CNA care. CONCLUSIONSChildren using HHC are a heterogeneous population who receive it from a variety of providers. Future investigations should explore the role of nonnurse caregivers, particularly with CMC.
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页数:9
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