Home-Based Clinical Services Are Safe and Effective But Underutilized
FOR IMMEDIATE RELEASE: July 13, 2023
Contact: Ellen Mullally
Home-based clinical services are a patient-centered, safe, and effective way to meet the clinical care needs of older adults with complex medical needs. However, a new study in the July issue of JAMDA indicated that many individuals who need and could benefit from such services don’t receive them.
In Use of Home-based Clinical Care and Long-Term Services and Supports Among Homebound Older Adults, the authors used data from the 2015 National Health and Aging Trends Study and found that only about 30% of homebound Medicare beneficiaries included in the study received any home-health services, the most common being some form of home-based clinical care. At the same time, 80% received some home-based long-term services and supports (LTSS), such as assistive devices and paid caregiving. The authors said those who received home-based clinical care were more likely to receive home-based LTSS.
Use of the most common types of home-based LTSS—assistive devices, home modifications, paid caregivers, and high family caregiving—was similar “regardless of the type of home-based clinical care used,” the authors said.
“While our findings describe…the need for home-based care, services, and supports, we see that many types of home-based services were used at low frequency,” the study authors said. “This confirms previous work indicating that forms of home-based clinical care are underutilized and suggests that several types of home-based LTSS—such as home-delivery meals—may be underutilized as well.”
Affordability of services may be an issue, they suggested, “especially given supports and services are covered by a patchwork of payers with substantial geographic variation.”
Future studies, the study team offered, should examine how various factors shape the receipt of home-based services and supports. At the same time, they said additional studies should consider “the wide range of ways people access home-based LTSS and prompt CMS to expand efforts to improve clinical and long-term integration for the larger population.”
This study was conducted by researchers at the Icahn School of Medicine at Mount Sinai, New York, NY; LeadingAge LTSS Center at UMass Boston, Washington, DC; Massachusetts General Hospital, Boston, MA; Johns Hopkins University School of Medicine, Baltimore, MD; and Johns Hopkins University School of Nursing, Baltimore, MD.
JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles, including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit www.jamda.com for more information.
About AMDA – The Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit www.paltc.org for more information.