Woman Refusing Home Healthcare

Why Some Patients Refuse Home Healthcare

A 2017 report from a roundtable provides some insights pertaining to problems that persist when it comes to home health care. The focus of discussion was on why some patients refuse home healthcare services, along with the clinical and economic consequences. The research report that was developed as a result of this discussion is entitled “I Can Take Care Of Myself!”1

The research report and roundtable forum were sponsored by two main entities. One sponsor was the United Hospital Fund, an independent nonprofit organization that analyzes public policy to inform decision-makers. The Alliance for Home Health Quality and Innovation, a research foundation dedicated to promoting the value of home health care to patients and the U.S. healthcare system was another backer. Both organizations recommended that steps needed to be taken when it came to discharging planning, research, and policy. It is hoped that these efforts would help more patients take advantage of the benefits available through home health care.

So, How Many Patients are Refusing Home Healthcare?
Two alarming study findings were revealed as a result of the research –

  • Between 6% and 28% of patients eligible for home health care services are choosing not to accept them.1
  • As a result, those patients refusing services seem to be more likely to be readmitted to a hospital due to consequent health issues and future incidents.

It was noted in the report that the idea of “Home health care may be considered by some as an unwelcome reminder of illness, frailty, and loss of independence…” Undoubtedly, these findings reflect the concerns that many home health agencies have expressed for decades. The truth is, as many people age, the realization of having to depend on others for help can be difficult to accept.

The report also expressed how concerning and “paradoxical” the patients’ service refusals appear to be. Upon hospital discharge, a large percentage of patients who are considered eligible for home health care services, decline them. Ultimately, this is a loss for both the patient and the caregivers.

Why Are They Refusing Services?
Unfortunately, the home health industry as a whole traditionally remains underused and underappreciated. Furthermore, its value is still grossly underestimated, and its services are misunderstood. These realities could be contributing to why patients are refusing services. However, the upshot is that the home health care profession needs to do an overall better job of explaining what it does. In this, the industry can further confirm its importance and how it brings value to patients and their families.

There remains a large unknown as to what causes patients to refuse home healthcare services. As it stands, it doesn’t appear to be one main factor but could be a combination of many. Factors such as, how the whole care process works, or how hospitals identify patients to refer to home health must be researched. How staff explains these services to patients and caregivers, as well as the explanation of financial obligations should also be investigated. These factors in combination, along with other patient-centered factors could all contribute to patient refusals.

What Can the Health Care Industry Do?
There are a host of ambitious recommendations that are currently being considered and investigated in order for the profession to take action. The goal in mind is to help patients obtain access to the home health services that they need and can certainly benefit from.

One such recommendation is to look at ways hospitals can improve discharge planning. Some hospitals are developing training sessions for nurses, doctors, and other medical staff to ensure, first, that they understand home healthcare services. On top of that, it is also being proposed that administration utilize practice scripts to help guide them through discussions with patients about home health service benefits and why they may be necessary.

The report also ventured into policies, urging the profession to initiate discussions with CMS about making Medicare eligibility requirements more flexible, particularly waivers required for homebound status. This could allow patients to receive services sooner than later, especially if services are urgently needed. The idea of establishing incentives, financial and otherwise, is also being considered as a goal for spreading awareness. Hospitals and healthcare systems would be informed about how home health care can help improve patient outcomes and lower readmissions.

Furthermore, there is a need for more research, particularly, qualitative and quantitative studies into the issue of patient refusals. In this, patients would be asked to complete a small survey on the discharge planners, hospitals, social workers and community providers. It is hoped that the survey results would help gauge how patients perceive and understand home healthcare services.

Is Home Healthcare Right for You?
The answer is YES if you are homebound and need consistent medical assistant services. What most patients who are considering home health services may not know, is that those who are currently receiving services are more likely to report a better quality of life. When it comes to home health, the benefits far outweigh the common misconceptions that patients, healthcare professionals, and administrators may have.

To learn more about home health services, connect with Progressive Home Health today at 512-312-5222. We’re here to inform, educate, and provide quality services that you and/or your loved one can benefit from.

1 Levine, C.; Lee, T. (2017, May). “I Can Take Care of Myself!”: Patients’ Refusals of Home Health Care Services. Retrieved – September 15, 2018, from Progressive Home Health Agency