@article{TEXTUAL,
      recid = {11196},
      author = {Bressman, Eric and Coe, Norma B. and Chen, Xinwei and  Konetzka, R. Tamara and Werner, Rachel M.},
      title = {Trends in Receipt of Help at Home after Hospital Discharge  among Older Adults in the US},
      journal = {JAMA Network Open},
      address = {2021-11-30},
      number = {TEXTUAL},
      abstract = {&lt;p&gt;Importance: With declining use of institutional  postacute care, more patients are going directly home after  hospital discharge. The consequences on the amount of help  needed at home after discharge are unknown.  &lt;/p&gt;&lt;p&gt;Objective: To estimate trends in the frequency and  duration of receipt of help with activities of daily living  (ADLs) among older adults discharged home.&lt;/p&gt;&lt;p&gt;Design,  Setting, and Participants: Repeated cross-sectional study  of a national sample of community-dwelling older adults who  returned home after hospital discharge from 2011 to 2017.  Participants included respondents to National Health and  Aging Trends Study (NHATS), an annual population-based,  nationally representative survey of Medicare beneficiaries,  who were 69 years or older and were discharged from an  acute care hospital to home during the years of the study.  A nationally representative sample was estimated using  NHATS' analytic weights. Unweighted frequencies and  weighted and unweighted percentages are reported. The  analysis was conducted from September 2020 to October 2021.  Exposures: Discharge from an acute care  hospitalization.&lt;/p&gt;&lt;p&gt;Main Outcomes and Measures: Receipt  of help with ADLs during the 3 months after hospital  discharge.&lt;/p&gt;&lt;p&gt;Results: Of the 3591 survey participants  who were discharged home from an acute care hospital during  the study period, 53.3% were female, 54.8% were married or  living with a partner, and the mean (SD) age was 78.5 (7.0)  years. Of these, 1710 (44.1%) reported receiving help  within 3 months of discharge. Compared with people not  receiving help, those receiving help were older (mean [SD]  years, 79.7 [7.5] years vs 77.6 [6.3] years), had worse  self-rated health at baseline (47.1% with fair or poor  health vs 26.5%) and were more likely to have dementia  (21.8% vs 5.5%). The percentage of respondents who reported  receiving help increased during the study period from 38.1%  of hospital discharges in 2011 to 51.5% in 2017. For those  who were independent in their ADLs before hospitalization,  the percentage receiving help after discharge more than  doubled over the study period increasing from 9.3%  receiving help in 2011 to 31.8% in 2017. Among patients who  did not receive Medicare-reimbursed home health, the  percentage receiving help also increased from 22.1% to  28.1%. Among those who received help after discharge, the  need for help slowly declined to prehospitalization levels  over the ensuing 9 months.&lt;/p&gt;&lt;p&gt;Conclusions and Relevance:  In this cross-sectional study, older adults' receipt of  help at home after hospital discharge increased from 2011  to 2017, including patients relying on non-Medicare funded  sources of care. As payers steer patients away from  inpatient postacute care facilities, policymakers will need  to pay attention to this shifting burden of care.&lt;/p&gt;},
      url = {http://knowledge.uchicago.edu/record/11196},
}