Continuity of care in home health is valued but poorly understood. This article is about the delivery of nursing care to elderly home health patients and to determine if visits provided by the same RN improve selected “Outcome and Assessment Information Set” outcomes. Functional status, psychological status, and use of emergent care were examined. Cases selected represented individuals aged 65 years and older, with at least one chronic illness and a good prognosis. Patients received four or more visits from the same RN.The clinical and administrative billing records from an initial 60-day period yielded a convenience sample of 887 discharged cases from a suburban, U.S. hospital-based home health agency. Higher levels of RN continuity were associated with a decreased likelihood of neuro/emotional/behavioral issues for patients at discharge. The findings showed no relationship of RN continuity of care to functional status and use of emergent care for the period examined.
Allen, B., Burt, P., Roychoudhury, C., & Chen, B. ( 2004). Analysis of OBQI outcomes in participating Michigan home health agencies. Journal of Nursing Care Quality, 19, 149-155.
2.
Bice, T., & Boxerman, S. ( 1977). A quantitative measure of continuity of care. Medical Care, 15, 347-349.
3.
Brooten, D., Youngblut, J., Deatrick, J., Naylor, M., & York, R. ( 2003). Patient problems, advanced practice nurse (APN) interventions, time and contacts among five patient groups. Journal of Nursing Scholarship, 35, 73-79.
4.
Christakis, D., Kazak, A., Wright, J., Zimmerman, F., & Connell, F. ( 2004). What factors are associated with achieving high continuity of care? Family Medicine, 36, 55-60.
5.
Christakis, D., & Lozano, P. ( 2003). Continuity of care is associated with early and consistent treatment of attention-deficit/ hyperactivity disorder during a single school year. Journal of Clinical Outcomes Management, 10, 371-375.
6.
Christakis, D., Mell, L., Wright, J., Davis, R., & Connell, F. ( 2000). The association between greater continuity of care and timely measles-mumps-rubella vaccination. American Journal of Public Health, 90, 962-965.
7.
Daly, B., Douglas, S., Kelly, C., O’Toole, E., & Montenegro, H. (2005). Trial of a disease management program to reduce hospital readmissions of the chronically critically ill . Chest, 128, 507-517.
8.
Durbin, J., Goering, P., Streiner, P., & Pink, G. ( 2004). Continuity of care: Validation of a new self-report measure for individuals using mental health services. Journal of Behavioral Health Services & Research, 31, 279-296.
9.
Fortney, J., Sullivan, G., Williams, K., Jackson, C., Morton, S., & Koegel, P. ( 2003). Measuring continuity of care for clients of public mental health systems. Health Services Research, 38, 1157-1175.
10.
French, D., Bass, E., Bradham, D., Campbell, R., & Rubenstein, L. (2008). Rehospitalization after hip fracture: predictions and prognosis from a national veterans study. Journal of the American Geriatric Society, 36, 705-710.
11.
Jasti, H., Mortensen, E., Obrosky, D., Kapoor, W., & Fine, M. ( 2008). Causes and risk factors of rehospitalization of patients hospitalized with community acquired pneumonia. Clinical Infectious Disease, 46, 550-556.
12.
McGhan, R., Radcliff, T., Fish, R., Sutherland, E., Welsh, C., & Make, B. ( 2007). Predictors of rehospitalization and death after severe exacerbation of COPD. Chest, 132, 1748-1755.
Moser, D., Doering, L., & Chung, M. ( 2005). Vulnerabilities of patients recovering from an exacerbation of chronic heart failure. American Heart Journal, 150, 984.
15.
National Quality Forum. (n.d.). NQF-endorsed standards. Retrieved October 8, 2009, from http://www.qualityforum.org/measures_List.aspx
16.
Needleman, J., Buerhaus, P., Mattke, S., Stewart, M., & Zelevinsky, K. (2001). Nurse staffing and patient outcomes in hospitals: Executive summary. Boston: Harvard School of Public Health.
17.
O’Brien-Pallas, L., Doran, D., Murray, M., Cockerill, R., Sidani, S., Laurie-Shaw, B., et al. (2001). Evaluation of a client care delivery model, Part 1: Variability in nursing utilization in community home nursing. Nursing Economics, 19, 267-276.
18.
O’Brien-Pallas, L., Doran, D., Murray, M., Cockerill, R., Sidani, S., Laurie-Shaw, B., et al. (2002). Evaluation of a client care delivery model, Part 2: Variability in nursing outcomes in community home nursing. Nursing Economics, 20, 13-21.
19.
Potter, T., & Peden-McAlpine, C. (2002). How expert home care nurses recognize early client status changes. Home Healthcare Nurse, 20, 43-50.
20.
Reid, R., Haggerty, J., & McKendry, R. ( 2002). Defusing the confusion: Concepts and measures of continuity of healthcare. Ottawa, Ontario, Canada: Canadian Health Services Research Foundation.
21.
Rosati, R., Muang, L., Navaie-Waliser, M., & Feldman, P. ( 2003). Risk factors for repeated hospitalizations among home healthcare recipients. Journal for Healthcare Quality, 25, 4-11.
22.
Ryndes, T., & Emanuel, L. ( 2003). Is discontinuity in palliative care a culpable act of omission?Hastings Center Report, 33(Special Suppl.), S45-S47.
23.
Sparbel, K., & Anderson, M. ( 2000a). A continuity of care integrated literature review: Part 2, Methodological issues. Journal of Nursing Scholarship, 32, 131-135.
24.
Sparbel, K., & Anderson, M. ( 2000b). Integrated literature review of continuity of care: Part 1, Conceptual issues. Journal of Nursing Scholarship , 32, 17-24.
25.
Turner, J.G., Larson, E.L., Korniewicz, D., Wible, J.M., Baigis-Smith, J., Butz, A., et al. (1994). Consistency and cost of home wound management by contract nurses. Public Health Nursing, 11, 337-342.
26.
U.S. General Accounting Office. (2000). Prospective payment system could reverse recent declines in spending (No. GAO/ HEHS-00-176). Washington, DC: Author.
27.
van Survellen, G., Fongwa, M., & Mockus-D’Errico, E. (2006). Continuity of care and quality care outcomes in disease management: A literature review. Nursing & Health Sciences, 8, 185-195.
28.
Woodward, C., Abelson, J., Tedford, S., & Hutchison, B. ( 2004). What is important to continuity in home care? Perspectives of key stakeholders. Social Science & Medicine, 58, 177-192.
29.
Zhang, J., Rathouz, P., & Chin, M. ( 2003). Comorbidity and the concentration of healthcare expenditures in older patients with heart failure. Journal of the American Geriatric Society, 51, 476-482.
