N10 Final Home Health Care

Feel free to add more . All help is welcomed. Lets share the study. To be continued on the rest of the final review.
Home health Hx
Started in the 1880s,
Early 20th century - NYC visiting nurse association (VNA) primarily for TB F/U visiting indigents in tenements
WWII - Physician shortage = increase in home nurses
1940s - Hospital based home health started
1965 - Medicare and Medicaid started to cover home health
1963 - 1,100 home health agencies vs now - 8,000 agencies
DRGs began in the 70 -80s for cost containment
Home health is cost efficient

Advantages
lower cost than hospitals
familiar surroundings increase comfort level
easier access to family support systems
removes the travel burden on family
restores some family control in care giving

Disadvantages
decreased family privacy
interuption of the family routine
loss of total family control in caregiving
healthy family members may resent time spent with person needing care
personality conflicts with visiting nurse
resentment can build if visiting nurse is controlling or pushy

Medicare is the largest single payor of Home care
36.6% - Medicare
28.1% - Out of Pocket
26.0% - Medicaid (MediCal)
18.9% - Private Insurance
12.3% - State and local Government
5.2% - Other
(don't ask me why these don't add up to 100%)

Requirement for pts receiveng home care
- Homebound
- Under the care of a physician
- Require skilled intervention

What is covered under Home Health
Nursing, PT, OT, SpeechT, medical social worker, home health aide
It has to be skilled care or it is not covered