Factors associated with achievement of goals for home health care.

With the introduction of Medicare's Prospective Payment System (PPS) and DRGs, the economic value of home health care services lies in its ability to reduce total patient care costs by the substitution of outpatient home care for inpatient hospital care. Analysis of service delivery patterns utilized by home health agencies in meeting goals for patient care will be an important ingredient in meeting these objectives. The purpose of this study was to determine if important patient characteristics known at the onset of home health care are predictive of utilization of home health services and/or the likelihood of meeting goals for home care established at the time of certification of care. Multivariate models were developed which predicted the odds of terminating with goals met based upon age, intensity of utilization, functional limitations, prognosis, presence of a caregiver, and type of patient condition. Results indicated that variability in likelihood of meeting goals for care is much better predicted by patient characteristics than by utilization of home care services.