Home health care in Arizona

Arizona Nurse, Mar 2000 by Long, Carol O

Discussion and Implications

The identification of resources and assessment of utilization necessitates data collection on the characteristics of home health care agencies, their financial status, their patients, and the attributes and qualifications of their personnel. An analysis of these findings assists legislators, health planners, and educators in describing, evaluating, and determining if patients who need home health care have access to it. Important decisions cannot be made without these data nor should this information be concealed or ignored. As the federal government advanced home health care reform by connecting patient outcomes, as in OASIS, to prospective payments, it is critical to determine if the integrity and philosophy of home health care remains intact. Information needed to make these decisions cannot occur in a vacuum. Rather, current and ongoing data must be collected so that the evidence of the data drives the decisions affecting those who need home health care and those who provide it.

Clearly, surveys conducted every 10 years in Arizona do not provide a strong enough basis for decisionmaking. They do not afford the opportunity to analyze the impact of policy on the home health care agencies, the patients they serve, or the nurses who staff these agencies. For example, one might ask, are beneficiaries in need of getting the services they require'? Has access to home health care, particularly in our rural areas, been denied due to closure of agencies? Are the patient's best interests served by the threat of being institutionalized due to the lack of home health care services or an agency's unwillingness to risk caring for patients who may require more services than the capitated agreement or prospective rate'? Has someone misplaced the evidence that suggests that home health care is cost-effective'! Only these questions can be addressed through thoughtful and deliberate evaluation of all of the data in making important decisions in health care today including the facts and figures on the current status of home health care in Arizona and throughout the nation.

About the Author: Dr. Carol Long is an assistant professor at the college of Nursing at Arizona State University. Carol teaches the Home Health Course for the baccalaureate students at ASU. Dr. Long is a member of AzNA, Sigma Theta Tau, and on the Board of the Arizona Association for Home Care.