Patients in Medicare Advantage (MA) insurance plans have lower 30-day hospital readmission rates than patients in traditional Medicare fee for service (FFS) plans, a new analysis has calculated.

The data, which cover the period 2005-2008, indicate an overall MA-patient readmission rate of 14.5%.  This figure was compared against a published measurement of FFS patients (collected in 2004), which found a 19.6% readmission rate for patients in those plans.

After adjusting the numbers according to patient risk—the severity of their conditions—it’s calculated that the MA group had a 13% to 20% lower hospital…

Hospitalized patients are experiencing shorter in-hospital stays due to increased use of home health care.  The cut in length of stay may be small—from 4.78 days to 4.59 days between 1998 and 2008—but by allowing home care to substitute for in-hospital care, the estimated  savings are big.

According to one calculation, for every $1,000 increase in home health agency staffing costs to take on the added load, hospitals have saved at least $1,500 and perhaps as much $2,300 from reduced hospital payrolls.  Put another way, in the year 2008, the reduction…

A new study of home-based telemonitoring suggests that there may be misunderstandings over the extent to which patients actually incorporate the feedback into their daily self-care routines.

The study¹ , carried out at three Veterans Administration sites, with 43 patients and nine nurses, found that:

• Almost three-quarters of the patients were fuzzy about why they had telemonitoring equipment in their homes, saying that it was there because the doctor said they had to be monitored
• A third of patients said they didn’t consider themselves experienced with electronic equipment
• More than a quarter of patients said…

In January, the Food and Drug Administration expanded the labeling of a pasteurized human blood product to allow adults and adolescents (age 13 and up) with  hereditary angioedema (HAE) to infuse the drug at home for laryngeal, facial, and abdominal attacks—after they have been trained to do so by a health professional.  Now, German researchers into this often-fatal condition have published a tiny study suggesting that children as young as seven years old can be successfully treated at home.

HAE occurs from genetic deficiency, either inherited or as a mutation in…

A home-based intensive exercise program may give frail elderly patients a fitness boost before they undergo elective hip replacement. The idea is to get them in better shape preoperatively so that they’ll be in better shape postoperatively. The results of a pilot trial are promising, and the premise is now being examined in a large, randomized, multi-center study.

The single-blind pilot trial enrolled 30 frail patients, all older than 65 years of age, who were split into two groups. The experimental group of 15 underwent an exercise program, focused on walking…

Literature reviews of clinical trials have reported that physical training can improve balance and reduce falls. But because controlled trial results do not always carry over to the ‘real world,’ a research team performed a community-based program to evaluate the effect of balance training on senior individuals who either had previously fallen or feared falling.

Participants’ balance was measured pre-program, at the conclusion of the 12-week training sessions, and nine months later. The team found that the 98 individuals in the experimental arm of the study had not only improved balance…

Concerned about older African-Americans, who are at high risk of depression but tend not to talk about it or receive appropriate care, a new clinical trial is examining whether home-based, non-drug treatment can relieve symptoms and improve quality of life.

The university-designed study is meant to be carried out by personnel at community-based organizations such as senior centers, and is being tested at one such center, which is screening attendees for depression.

The single-blind, randomized study has an enrollment of 208 patients who have shown symptoms of depression on two successive questionnaires….

A pilot study of patients’ responses to information on their vital signs suggests that responses differ according to whether the information is delivered face-to-face by the home health nurse or by telemonitoring equipment in the home.

It seems, for example, that patients learning their blood pressure is outside the normal range are more likely to worry, or ask more questions, if they receive the info face-to-face than through the telemonitoring equipment.

When receiving the information via equipment, patients seem more likely to passively accept the results.  Face-to-face, patients are more likely to…

Individuals who require skilled care from a home health agency have been found to do better when tended by nurses with whom they have a prior relationship—nurses who know and understand them, and who can more readily detect physical changes in the patients’ physical status.

Only to be expected, you say? But would you expect that greater continuity of care is not simply a matter of patients ‘feeling better,’ but can affect the patients’ need for hospitalization and thus the monetary cost to the community?

This has now been demonstrated in two…

In a surprising outcome, women with post-partum depression given 12 weeks of home counseling/help from their peers—women who’d had post-partum depression in the past—didn’t seem to like it. At least, they did no better than a control group of women who received only two weeks’ of counseling. Post-partum depression might better be dealt with by professional nurses, the researchers now suggest.

The double-blind, randomized trial enrolled 60 post-partum-depressed women, 27 in the 12-week group , and 33 in the 2-week group (controls), who had validated postnatal depression and a baby less…