Effect of Age-Friendly Care on Days at Home Post-Hospital Discharge for Traditional Medicare Patients: A Cross-Sectional Study
The Bundled Payment for Care Improvement Advanced (BPCI-A) model encourages value-based care by bundling 90-day healthcare-related costs into a single payment for eligible service codes and procedures for traditional Medicare Part A and B beneficiaries. Our institution, an Age-Friendly Health System...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2025-03-01
|
| Series: | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| Online Access: | https://doi.org/10.1177/00469580251324408 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850225457489772544 |
|---|---|
| author | Kathleen Drago MD Bryanna De Lima MPH Sophie Rasmussen MBA Alaina Ena RN, MN Elizabeth Eckstrom MD, MPH Ella Bowman MD, PhD |
| author_facet | Kathleen Drago MD Bryanna De Lima MPH Sophie Rasmussen MBA Alaina Ena RN, MN Elizabeth Eckstrom MD, MPH Ella Bowman MD, PhD |
| author_sort | Kathleen Drago MD |
| collection | DOAJ |
| description | The Bundled Payment for Care Improvement Advanced (BPCI-A) model encourages value-based care by bundling 90-day healthcare-related costs into a single payment for eligible service codes and procedures for traditional Medicare Part A and B beneficiaries. Our institution, an Age-Friendly Health Systems Level 2 certified academic health center, participated in the BPCI-A model from 2018 to 2022. This study aimed to determine differences in days spent at home in the 30- and 90-day post-hospitalization period for older patients in the BPCI-A program based on Age-Friendly care status. Descriptive analyses assessed differences among patients who received Age-Friendly care (n = 275) and those who did not (n = 348). Zero-one-inflated beta regression models with propensity score matching compared the probability of spending days at home between groups. Sensitivity analyses were conducted. Age-Friendly care recipients tended to be older males with non-emergent admissions and lower risk-adjusted mortality scores ( P < .05). No significant differences were shown between groups at 30- and 90-days post-discharge for the original analysis. Sensitivity analyses found the probability of spending all eligible days at a facility 30-days post discharge significantly higher for those not receiving Age-Friendly care compared to those receiving Age-Friendly care ( P < .05). Admissions receiving at least 3Ms resulted in less days in a facility within 30 days of discharge. This highlights the importance of patient-centered and value-based care during the hospital stay. Future studies should continue to explore days at home as a patient-centered outcome measure and how comprehensive Age-Friendly care impacts days at home for a larger cohort. |
| format | Article |
| id | doaj-art-d1f5685b5bb845aa95348371cc552f9e |
| institution | OA Journals |
| issn | 0046-9580 1945-7243 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| spelling | doaj-art-d1f5685b5bb845aa95348371cc552f9e2025-08-20T02:05:20ZengSAGE PublishingInquiry: The Journal of Health Care Organization, Provision, and Financing0046-95801945-72432025-03-016210.1177/00469580251324408Effect of Age-Friendly Care on Days at Home Post-Hospital Discharge for Traditional Medicare Patients: A Cross-Sectional StudyKathleen Drago MD0Bryanna De Lima MPH1Sophie Rasmussen MBA2Alaina Ena RN, MN3Elizabeth Eckstrom MD, MPH4Ella Bowman MD, PhD5Division of General Internal Medicine & Geriatrics,Oregon Health & Science University, Portland, OR, USADivision of General Internal Medicine & Geriatrics,Oregon Health & Science University, Portland, OR, USADepartment of Quality Management, Oregon Health & Science University, Portland, OR, USADivision of General Internal Medicine & Geriatrics,Oregon Health & Science University, Portland, OR, USADivision of General Internal Medicine & Geriatrics,Oregon Health & Science University, Portland, OR, USADivision of General Internal Medicine & Geriatrics,Oregon Health & Science University, Portland, OR, USAThe Bundled Payment for Care Improvement Advanced (BPCI-A) model encourages value-based care by bundling 90-day healthcare-related costs into a single payment for eligible service codes and procedures for traditional Medicare Part A and B beneficiaries. Our institution, an Age-Friendly Health Systems Level 2 certified academic health center, participated in the BPCI-A model from 2018 to 2022. This study aimed to determine differences in days spent at home in the 30- and 90-day post-hospitalization period for older patients in the BPCI-A program based on Age-Friendly care status. Descriptive analyses assessed differences among patients who received Age-Friendly care (n = 275) and those who did not (n = 348). Zero-one-inflated beta regression models with propensity score matching compared the probability of spending days at home between groups. Sensitivity analyses were conducted. Age-Friendly care recipients tended to be older males with non-emergent admissions and lower risk-adjusted mortality scores ( P < .05). No significant differences were shown between groups at 30- and 90-days post-discharge for the original analysis. Sensitivity analyses found the probability of spending all eligible days at a facility 30-days post discharge significantly higher for those not receiving Age-Friendly care compared to those receiving Age-Friendly care ( P < .05). Admissions receiving at least 3Ms resulted in less days in a facility within 30 days of discharge. This highlights the importance of patient-centered and value-based care during the hospital stay. Future studies should continue to explore days at home as a patient-centered outcome measure and how comprehensive Age-Friendly care impacts days at home for a larger cohort.https://doi.org/10.1177/00469580251324408 |
| spellingShingle | Kathleen Drago MD Bryanna De Lima MPH Sophie Rasmussen MBA Alaina Ena RN, MN Elizabeth Eckstrom MD, MPH Ella Bowman MD, PhD Effect of Age-Friendly Care on Days at Home Post-Hospital Discharge for Traditional Medicare Patients: A Cross-Sectional Study Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| title | Effect of Age-Friendly Care on Days at Home Post-Hospital Discharge for Traditional Medicare Patients: A Cross-Sectional Study |
| title_full | Effect of Age-Friendly Care on Days at Home Post-Hospital Discharge for Traditional Medicare Patients: A Cross-Sectional Study |
| title_fullStr | Effect of Age-Friendly Care on Days at Home Post-Hospital Discharge for Traditional Medicare Patients: A Cross-Sectional Study |
| title_full_unstemmed | Effect of Age-Friendly Care on Days at Home Post-Hospital Discharge for Traditional Medicare Patients: A Cross-Sectional Study |
| title_short | Effect of Age-Friendly Care on Days at Home Post-Hospital Discharge for Traditional Medicare Patients: A Cross-Sectional Study |
| title_sort | effect of age friendly care on days at home post hospital discharge for traditional medicare patients a cross sectional study |
| url | https://doi.org/10.1177/00469580251324408 |
| work_keys_str_mv | AT kathleendragomd effectofagefriendlycareondaysathomeposthospitaldischargefortraditionalmedicarepatientsacrosssectionalstudy AT bryannadelimamph effectofagefriendlycareondaysathomeposthospitaldischargefortraditionalmedicarepatientsacrosssectionalstudy AT sophierasmussenmba effectofagefriendlycareondaysathomeposthospitaldischargefortraditionalmedicarepatientsacrosssectionalstudy AT alainaenarnmn effectofagefriendlycareondaysathomeposthospitaldischargefortraditionalmedicarepatientsacrosssectionalstudy AT elizabetheckstrommdmph effectofagefriendlycareondaysathomeposthospitaldischargefortraditionalmedicarepatientsacrosssectionalstudy AT ellabowmanmdphd effectofagefriendlycareondaysathomeposthospitaldischargefortraditionalmedicarepatientsacrosssectionalstudy |