Chartbook on Patient Safety

Patient Safety in the Home Health Setting

• Home health care is the fastest growing sector in the health care industry, with 66 percent growth projected over the next 10 years (Gershon, et al.).
• Improvements among home health patients can reflect the quality of care from home health agencies.
• Measures include:
  • Home health patients with improvement in surgical wounds.
  • Home health patients with improvements in their ability to take medications orally.

Home Health Patients With Surgical Wounds

Home health patients with improvement in surgical wounds, by age and race/ethnicity, 2010-2012

Left Chart:

Right Chart:

Key: NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native.

Source: Centers for Medicare & Medicaid Services, Outcome and Assessment Information Set, 2010-2012.

Denominator: Number of home health episodes during the measurement period in which the patient had a surgical wound and the episode ended with the patient discharged from home health care.

Note:  In 2011, the top 5 State achievable benchmark was 91.3 percent. The States that contributed to the benchmark were Alabama, Mississippi, Nevada, Oklahoma, and South Carolina. White, Black, and Asian are non-Hispanic. Hispanic includes all races.

• Importance: Normal wound healing after an operation is an important marker of good care. The home health team should regularly change wound dressing and teach the patient about wound care.
• Overall Rate: In 2012, the percentage of home health patients with improvement in their surgical wounds was 88.6%.

Home Health Patients Able To Take Oral Medications Correctly

Home health patients with improvement in their ability to take medications orally, by age and race/ethnicity, 2010-2012

Left Chart:

Right Chart:

Key: NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native.

Source: Centers for Medicare & Medicaid Services, Outcome and Assessment Information Set, 2010-2012.

Denominator: Number of home health episodes of care in which a patient was unable to take oral medications independently at the start of the episode that ended during the measurement period.

Note: In 2011, the top 5 State achievable benchmark was 55.2 percent. The States that contributed to the achievable benchmark were Iowa, Massachusetts, New Jersey, North Dakota, and South Carolina. White, Black, and Asian are non-Hispanic. Hispanic includes all races.

• Importance: Taking medications correctly is important to the health status and quality of life of individuals living in the community. The home health team can help teach a patient ways to organize drugs and take them properly.
• Overall Rate: In 2012, the percentage of home health patients with improvement in their ability to take medications orally was 49.7%.
• Groups With Disparities:
  • In 2012, home health patients in the oldest group, 85 years and over, had the lowest percentage with improvement in their ability to take medications orally.
  • The percentages with improved ability to take medications orally was also lower among Hispanic and Asian home health patients than among White patients.
• Achievable Benchmark: The benchmark was achieved among home health patients ages 0-64 years and 65-74 years.

Geographic Variation in Ability To Take Medications Orally

Home health patients with improvement in their ability to take medications orally, by race and ethnicity, by State, 2012

Source: Centers for Medicare & Medicaid Services, Outcome and Assessment Information Set, 2012.

Denominator: Number of home health episodes of care in which a patient was unable to take oral medications independently at the start of the episode that ended during the measurement period.

• Geographic Variation: In 2012, Hispanic home health patients had worse rates of improvement in taking oral medications than non-Hispanic White patients in eight States—Florida, Hawaii, Illinois, Iowa, Massachusetts, Nevada, New York, and Texas. Non-Hispanic White patients had worse rates of improvement than Hispanic patients in two States—Michigan and Pennsylvania.

Return to Contents