Cognitive impairment associated with greater care intensity during home health care

Abstract

Background: In Medicare-funded home health care (HHC), one in three patients has cognitive impairment (CI), but little is known about the care intensity they receive in this setting. Recent HHC reimbursement changes fail to adjust for patient CI, potentially creating a financial disincentive to caring for these individuals. Methods: This cohort study included a nationally representative sample of 1214 Medicare HHC patients between 2011 and 2016. Multivariable logistic and negative binomial regressions modelled the relationship between patient CI and care intensity—measured as the number and type of visits received during HHC and likelihood of receiving multiple successive HHC episodes. Results: Patients with CI had 45% (P