The Effects of Home Health Visit Length on Hospital Readmission

36 Pages Posted: 2 May 2018 Last revised: 15 Feb 2023

See all articles by Elena Andreyeva

Elena Andreyeva

University of Pennsylvania - The Wharton School

Guy David

The Wharton School, University of Pennsylvania - Health Care Management

Hummy Song

University of Pennsylvania - The Wharton School

Date Written: April 2018

Abstract

Home health care has experienced significant growth as an industry and is viewed as one of the avenues for achieving reductions in the cost and utilization of expensive downstream health care services. Using a novel dataset on home health care visits, this study quantifies the effects of reduced time spent with patients during a post-acute home health visit on hospital readmissions. We focus in particular on the subset of patients with conditions that are subject to penalty under the Hospital Readmission Reduction Program. Since both visit length and readmission risk are likely to be correlated with unobserved illness severity, we use the daily sequence of provider visits and deviation from the provider’s average daily workload as instruments for visit length. We find that patients who are visited later in the provider’s day as well as those who are visited by a provider who has a higher than usual workload experience home health visits that are shorter than usual. Using our instruments and controlling for patient, visit, and provider characteristics, we find that home health visits that are longer than usual by one minute reduce the risk of hospital readmission by approximately 8 percent. These effects seem to be driven by providers with higher levels of discretion in their time management and care provision. We suggest several approaches that managers could take to attain reductions in readmissions without incurring significant additional costs.

Suggested Citation

Andreyeva, Elena and David, Guy and Song, Hummy, The Effects of Home Health Visit Length on Hospital Readmission (April 2018). NBER Working Paper No. w24566, Available at SSRN: https://ssrn.com/abstract=3170800

Elena Andreyeva (Contact Author)

University of Pennsylvania - The Wharton School ( email )

3641 Locust Walk
Philadelphia, PA 19104-6365
United States

Guy David

The Wharton School, University of Pennsylvania - Health Care Management ( email )

3641 Locust Walk
Colonial Penn Center
Philadelphia, PA 19104-6358
United States

HOME PAGE: http://www.wharton.upenn.edu/faculty/david.html

Hummy Song

University of Pennsylvania - The Wharton School ( email )

3730 Walnut Street
Philadelphia, PA 19104
United States

Do you have negative results from your research you’d like to share?

Paper statistics

Downloads
88
Abstract Views
453
Rank
520,319
PlumX Metrics