In a recent article, we looked at evidence for alternative care at home for long-stay hospital patients. We also looked at the cost of this care and the options available to families. Lastly, we looked at the differences between home care and institutional care. You can learn more about these care options by reading on.
Evidence for alternative care at home for patients receiving long-stay hospital care
Evidence for alternative care at home (AHCaH) is emerging as an important tool for health care organizations. The AHCaH program reimburses Medicare-certified hospitals for inpatient services provided to patients at home. Inpatient services can include infusions, oxygen delivery, diagnostic labs, radiology, patient transportation, durable medical equipment, social work, and more. In addition, hospitals must provide specific inpatient services for patients receiving AHCaH, including the use of nebulizers, oxygen delivery, and patient safety.
This type of care is often used to relieve the burden of hospitalization. Medicare beneficiaries can receive home health services by enrolling in Medicare Fee-for-Service or through non-managed Medicaid in some states. Avalere Health conducted an extensive literature review and interviews with key stakeholders. These individuals were identified based on their experience as health care policymakers and payers.
Options available to caregivers
There are several options available to caregivers who want to provide alternative care in their homes for their loved ones. The state Medicaid plan offers options for paid caregivers, such as the Community First Choice option, which pays caregivers to provide care at home for eligible Medicaid participants. Another option is the Medicaid waiver program, which helps participants hire caregivers and cover the cost of their services.
In addition to in-home care, the ALTCS program also offers member-directed options that give caregivers more flexibility and control over the care they provide. These include personal care, homemaker services, and attendant care. Among these options is Self Directed Attendant Care, which provides caregivers with more flexibility in their schedules. The legal employer for these caregivers is the member’s legal guardian, who then pays the caregiver and handles all taxes, payroll withholding, and paychecks.
Comparisons with institutional care
The aim of this systematic review was to identify and synthesize systematic reviews that compare home care with alternative locations of care. The search strategy used a combination of keywords and subject headings to identify systematic reviews that compare home care with other care settings. Keywords included the terms ‘home care’ and ‘alternative care settings’. The systematic reviews were conducted on databases including MEDLINE and Cochrane Library. They spanned the period between the creation of the journals in June 2016.
The mixed findings of the studies could be due to a variety of reasons, including varying standards of care in different countries and sectors. For example, the standards of residential care in less developed countries could be lower than those in developed countries, or the resources available may be inferior to those in developed nations. The results may also be influenced by the year that the studies were conducted.
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