Home Care Worker Continuity in Home-Based Long-Term Care: Associated Factors and Relationships With Client Health and Well-Being.

Autor:	Reckrey JM; Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA., Russell D; VNS Health Center for Home Care Policy & Research, New York City, New York, USA.; Department of Sociology, Appalachian State University, Boone, North Carolina, USA., Fong MC; L&M Policy Research, Washington, District of Columbia, USA., Burgdorf JG; VNS Health Center for Home Care Policy & Research, New York City, New York, USA., Franzosa EC; Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.; James J. Peters VA Medical Center, Bronx, New York, USA., Travers JL; NYU Rory Meyers College of Nursing, New York City, New York, USA., Ornstein KA; Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
Jazyk:	angličtina
Zdroj:	Innovation in aging [Innov Aging] 2024 Feb 23; Vol. 8 (3), pp. igae024. Date of Electronic Publication: 2024 Feb 23 (Print Publication: 2024).
DOI:	10.1093/geroni/igae024
Abstrakt:	Background and Objectives: Despite the importance of provider continuity across healthcare settings, continuity among home care workers who provide hands-on long-term care is understudied. This project describes home care worker continuity, identifies factors associated with increased continuity, and examines associations between continuity and client outcomes. Research Design and Methods: We conducted a retrospective cohort study of clients receiving Medicaid-funded home-based long-term care ( n = 3,864) using insurance plan and home care agency data from a large nonprofit organization. We estimated home care worker continuity for clients between 6-month clinical assessments using Bice-Boxerman scores. We then used generalized estimating equations to model associations between home care worker continuity and (1) client characteristics (e.g., cognitive impairment), and (2) client functional, health, and psychosocial outcomes. Results: While home care worker continuity was lowest for clients receiving the most weekly care hours, a range of continuity existed across all levels of care need. Those who were male, older, Asian/Pacific Islander/Native American, cognitively impaired, and functionally impaired had lower continuity. Higher home care worker continuity was significantly associated ( p < .05) with fewer falls, a higher likelihood of functional improvement/stabilization, and fewer depressive symptoms. Discussion and Implications: The finding that home care worker continuity is associated with the health and well-being of home-based long-term care clients underscores the importance of building high-quality relationships in long-term care. Continued efforts are necessary to understand and advance home care worker continuity and to identify other aspects of the home care experience that benefit those receiving long-term care at home. Competing Interests: None. (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.)
Databáze:	MEDLINE
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