Continuity of Nursing Care in Home Health and Its Effect on Hospital Readmission: A Retrospective Analysis
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Use of home health care (HHC) has burgeoned in recent years. This is largely a response to demographic shifts such as an aging population, rising health care costs, and the availability of technology that makes the home a more viable setting of care delivery (Landers et al., 2016). Investment in HHC has also grown, as expenditure on HHC is expected to exceed $150 billion by 2021 (Parker, Zimmerman, Rodriguez, & Lee, 2014). Two major indicators of care quality are 30-day acute hospital readmissions (AHRs) and nursing care continuity (CC), and sources in the literature indicate a connection between the level of CC and this clinical outcome (David & Kim, 2018). It is the purpose of this project to examine any relationship between these two quality indicators. The theoretical framework applied in this project is King’s Theory of Goal Attainment, which examines the interactions at three systems levels in order to guide care improvement and promote patient health (King, 1992). A retrospective study design was used in this project, and charts at a local HHC agency were reviewed to determine levels of CC for a high-risk patient sample. The comparative risk of AHRs for patients with varying levels of CC was done using binary logistic regression. Results of the project include a significantly reduced odds of readmission as COCI increased by increments of 0.1 (aOR=3.02 95% CI=1.016-8.97, p=.047). Neither continuity groups nor demographic variables had a significant effect, however. This initial research serves to validate continuity as a crucial quality measure.