The metrics in this table make one thing clear: Home Health Care produces better outcomes. We look at patients from the facility on the page who were coded for Home Health Care at discharge. We then compare the stats for that population, comparing those who received home care versus those who did not receive home care.
The patient population in this table is limited to Inpatient discharges. Also, the reporting period is offset from other tables on the page to maintain patient confidentiality.
Understanding the Metrics
There are two rows in the table. The top row contains data for patients who were admitted to home health care. The bottom row contains data for patients who were not admitted to home care.
|Total||This column contains the total count of distinct patients who were coded for home health care at discharge from the selected facility relative to the subcategory specified in the row header.|
|Percent of All Inpatient||This Facility||The percent of total patients who were coded for Home Health care at discharge from the facility on this page relative to the subcategory specified by the row header. If this number is far below the county and state averages, it might be indicative of a situation where discharge planning at the facility needs to be improved.|
|County and State Averages||These columns contain the parallel county and state averages for the first metric in the section.|
|Percent of All Patients who received Discharge Instructions||This Facility||This metric shows the relative percentages of patients who were coded for home care at discharge. These two numbers will total to 100%. This allows a quick comparison of coded patients who were admitted to home care versus those who did not.|
|County and State Averages||These columns reveal the comparative county and state averages for patients coded for home health at discharge.|
|% Readmitted: 30 days||This Facility||This is the % Readmitted rate for the patient subcategory in each row. Invariably this shows the distinct advantage to the hospital provided by patients adhering to discharge coding. That is, they are admitted to home health care.|
|County and State Averages||These columns contain the county and state comparative readmission rates. If the facility % Readmission rates are significantly higher than the county and state averages, this indicates an area of attention required by the hospital.|
Even though the table includes "Instructions" in the name, you should not construe that any instructions were given to any patient. What is counted in this table are patients who were coded for home care at discharge. For more information, see How are Facility Discharge Instruction Codes Determined?
Even in the best situation, not every patient will be admitted to the same post-acute care as they were coded for at discharge. Nevertheless, with increasing effort to code properly and communicate the advantages and even necessity of post-acute care, we can push the overall success rate of post discharge adherence always closer to 100%.
In the case of home health care, there is a critical advantage that this table highlights.
The data in this table should be used in close conjunction to the metrics contained in the Post Acute Destinations/Discharge Metrics table.
First, we look at the PAD Table:
The metrics in the box are the focus. 2,456 patients were coded for home care at discharge, but, of those patients, only 1,742 were admitted to home health care. For this facility, that leaves 714 patients who were coded for home care but who were not admitted. Let's take a look at what this means to the hospital.
This table has been revised to focus on the data most relevant to this example.
This table includes only patients who were coded for home care. If we compare the readmission rates for patients who were admitted to home care versus those not admitted, we see that there is a 7.0 percent advantage when patients are admitted to home care.
We can put these two numbers together: 714 patients were coded for home care who were not admitted. From our Readmission metrics, we know that 7.0% fewer of those 714 would re-admit to a hospital if they had received Home care; that is 50 patients for this hospital who would likely not readmit if they were admitted to home care. This is a valuable message to take to a hospital to encourage a partnership to strengthen discharge planning and patient adherence.
Why Don't the Counts match?
If we look at the PAD table on the top we see that there were 2,456 patients discharged from inpatient care who were coded for home care. In the lower table, if we add up the two rows, we would expect to see the same number, but instead, the total is 2,468.
The data for these two table is pulled from two different one year periods.
Although the metrics are the same the counts come from two different periods. Because CMS provides data based on the close date of a billing episode, we are unable to align all inpatient discharges with a completed home care billing episode. In order to get the most complete data, we move the reporting period back by a quarter to make sure that we have the most complete metrics.