CLASSIFYING HOME HEALTH PATIENTS BASED ON NURSING RESOURCE CONSUMPTION: MODEL DEVELOPMENT AND VALIDATION.
Contributors: Rush University, College Of Nursing.
Published: 1990
Number of pages: 198
Subjects: Health Sciences, Nursing.
Description: Homecare reimbursement structures and management practices currently fail to reflect variability in nursing resource consumption. At the same time the level of complexity of care required by sicker patients is escalating and expanding the scope of clinical practice in homecare nursing.

The purpose of this study was to design and test the validity of a patient classification model for homecare based on nursing resource consumption. The nine item factor evaluation classification model was developed by clinical staff and tested at a large urban hospital based home health agency. Nursing resource consumption was operationally defined as the amount of direct care time spent during a home visit, along with previsit preparation and postvisit followup. Interrater agreement for the classification system achieved prior to the final testing was 93%.

Barcode scanning technology was used to collect real time data from a convenience sample of 404 home visits made by 15 nurses over a three week period. Demographic and clinical information were also collected for each patient.

Findings revealed that the mean direct care time was 70.6 minutes per visit (s.d. = 43.8 minutes). Over 57% of the visits lasted 60 minutes or more. Regression analyses were performed to determine which variables were predictive of direct care time. Assessment was the strongest predictor of direct care time. A regression equation combining classification model indicators with clinical and demographic information accounted for 42.38% of the variance in direct care time for the sample visits. Discriminant analyses were performed to determine the ability of the model indicators and other variables to separate the visits into groups based on visit length. Slightly over 71% of the visits were correctly classified.

This study confirmed the variability of resource use by homecare patients, and identified variables that describe patients' requirements for home nursing care. Further study is needed to refine the model for use in clinical practice.
Notes: Source: Dissertation Abstracts International, Volume: 51-04, Section: B, page: 1745.

Thesis (D.N.SC.)--RUSH UNIVERSITY, COLLEGE OF NURSING, 1990.

School code: 0591.