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Brief ReportBrief Report

Home Health Care Workers' Interactions with Medical Providers, Home Care Agencies, and Family Members for Patients with Heart Failure

Madeline R. Sterling, Joanna Bryan Ringel, Barbara Riegel, Parag Goyal, Alicia I. Arbaje, Kathryn H. Bowles, Margaret V. McDonald and Lisa M. Kern
The Journal of the American Board of Family Medicine March 2023, jabfm.2022.220204R2; DOI: https://doi.org/10.3122/jabfm.2022.220204R2
Madeline R. Sterling
From the Weill Cornell Medicine, New York, NY (MRS, JBR, PG, LMK); University of Pennsylvania School of Nursing, Philadelphia (BR, KHB); Johns Hopkins University School of Medicine, Baltimore, MD (AIA); Center for Home Care Policy & Research at VNS Health, New York, NY (KHB, MVM).
MD, MPH, MS
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Joanna Bryan Ringel
From the Weill Cornell Medicine, New York, NY (MRS, JBR, PG, LMK); University of Pennsylvania School of Nursing, Philadelphia (BR, KHB); Johns Hopkins University School of Medicine, Baltimore, MD (AIA); Center for Home Care Policy & Research at VNS Health, New York, NY (KHB, MVM).
MPH
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Barbara Riegel
From the Weill Cornell Medicine, New York, NY (MRS, JBR, PG, LMK); University of Pennsylvania School of Nursing, Philadelphia (BR, KHB); Johns Hopkins University School of Medicine, Baltimore, MD (AIA); Center for Home Care Policy & Research at VNS Health, New York, NY (KHB, MVM).
PhD, RN, FAAN, FAHA
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Parag Goyal
From the Weill Cornell Medicine, New York, NY (MRS, JBR, PG, LMK); University of Pennsylvania School of Nursing, Philadelphia (BR, KHB); Johns Hopkins University School of Medicine, Baltimore, MD (AIA); Center for Home Care Policy & Research at VNS Health, New York, NY (KHB, MVM).
MD, MSc
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Alicia I. Arbaje
From the Weill Cornell Medicine, New York, NY (MRS, JBR, PG, LMK); University of Pennsylvania School of Nursing, Philadelphia (BR, KHB); Johns Hopkins University School of Medicine, Baltimore, MD (AIA); Center for Home Care Policy & Research at VNS Health, New York, NY (KHB, MVM).
MD, MPH, PhD, MPH
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Kathryn H. Bowles
From the Weill Cornell Medicine, New York, NY (MRS, JBR, PG, LMK); University of Pennsylvania School of Nursing, Philadelphia (BR, KHB); Johns Hopkins University School of Medicine, Baltimore, MD (AIA); Center for Home Care Policy & Research at VNS Health, New York, NY (KHB, MVM).
PhD, RN, FAAN, FACMI
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Margaret V. McDonald
From the Weill Cornell Medicine, New York, NY (MRS, JBR, PG, LMK); University of Pennsylvania School of Nursing, Philadelphia (BR, KHB); Johns Hopkins University School of Medicine, Baltimore, MD (AIA); Center for Home Care Policy & Research at VNS Health, New York, NY (KHB, MVM).
MSW
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Lisa M. Kern
From the Weill Cornell Medicine, New York, NY (MRS, JBR, PG, LMK); University of Pennsylvania School of Nursing, Philadelphia (BR, KHB); Johns Hopkins University School of Medicine, Baltimore, MD (AIA); Center for Home Care Policy & Research at VNS Health, New York, NY (KHB, MVM).
MD, MPH
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Article Figures & Data

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    Figure 1.

    Scope of home health care workers' interactions with clinicians, health systems, and family caregivers, visually displayed with medians and interquartile ranges (IQRs). Abbreviations: HF, heart failure patients, HHWs, home health care workers.

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    Exclusion Cascade. Abbreviation: HHWs, home health care workers.

Tables

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    Table 1.

    Scope of Home Health Care Workers' Interactions with Clinicians, Health Systems, and Family Caregivers of Heart Failure Patients

    Survey QuestionsValue
    About how many different doctors' appointments have you taken your client with heart failure to in the last year?n = 343
    072 (21.0%)
    130 (8.7%)
    248 (14.0%)
    341 (12.0%)
    430 (8.7%)
    519 (5.5%)
    628 (8.2%)
    ≥775 (21.9%)
    If you accompanied a client with heart failure to doctors' appointments in the last year, about how many different doctors were those appointments with (counting only one doctor per appointment)?*n*= 259
    156 (21.6%)
    272 (27.8%)
    348 (18.5%)
    432 (12.4%)
    ≥551 (19.7%)
    If you accompanied a client with heart failure to doctors' appointments in the last year, about how many different health systems were those appointments in?*n*= 254
    1124 (48.8%)
    271 (28.0%)
    ≥359 (23.2%)
    For your client with heart failure, about how many other home health care workers were assigned to the same client over the last year?n = 352
    061 (17.3%)
    164 (18.2%)
    2137 (38.9%)
    336 (10.2%)
    ≥454 (15.3%)
    For your client with heart failure, about how many different nursing supervisors did you work with over the last year?n = 360
    043 (11.9%)
    194 (26.1%)
    2134 (37.2%)
    ≥389 (24.7%)
    For your client with heart failure, about how many different family members did you organize care with over the last year?n = 364
    080 (22.0%)
    1159 (43.7%)
    268 (18.7%)
    334 (9.3%)
    ≥423 (6.3%)
    • Responses were left as continuous values; values above 75th percentile were categorized together.

    • Missing for each question includes: # of doctors' appointments (n = 48), # of different doctors (n = 132), # of different health systems (n = 137), # of home health care workers assigned to same client (n = 39), # of different nursing supervisors (n = 31), # of different family members organized care with (n = 27).

    • ↵* Had to answer 1st question to respond to questions 2 and 3.

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    Table 2.

    Characteristics of Study Participants

    CharacteristicsValue
    n391
    Age (in years), mean (SD)48.5 (11.5)
    Gender
    Men9 (2.3%)
    Women382 (97.7%)
    Race/ethnicity
    Non-Hispanic White30 (7.7%)
    Non-Hispanic Black80 (20.5%)
    Hispanic234 (60.0%)
    Asian/Pacific Islander7 (1.8%)
    Other39 (10.0%)
    Were you born in the United States?
    No343 (87.7%)
    Yes48 (12.3%)
    How many years have you lived in the United States? Median (IQR)19 (9, 30)
    How many years have you been a home care worker? Median (IQR)10 (5, 17)
    As a home care worker, about how many clients have you cared for with heart failure
    1 to 5281 (71.9%)
    6 to 1048 (12.3%)
    11 to 158 (2.0%)
    More than 1512 (3.1%)
    Not sure42 (10.7%)
    • Fifty-six unique agencies represented in the analytic sample.

    • Abbreviations: SD, standard deviation; IQR, interquartile range.

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The Journal of the American Board of Family     Medicine: 38 (1)
The Journal of the American Board of Family Medicine
Vol. 38, Issue 1
January-February 2025
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Home Health Care Workers' Interactions with Medical Providers, Home Care Agencies, and Family Members for Patients with Heart Failure
Madeline R. Sterling, Joanna Bryan Ringel, Barbara Riegel, Parag Goyal, Alicia I. Arbaje, Kathryn H. Bowles, Margaret V. McDonald, Lisa M. Kern
The Journal of the American Board of Family Medicine Mar 2023, jabfm.2022.220204R2; DOI: 10.3122/jabfm.2022.220204R2

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Home Health Care Workers' Interactions with Medical Providers, Home Care Agencies, and Family Members for Patients with Heart Failure
Madeline R. Sterling, Joanna Bryan Ringel, Barbara Riegel, Parag Goyal, Alicia I. Arbaje, Kathryn H. Bowles, Margaret V. McDonald, Lisa M. Kern
The Journal of the American Board of Family Medicine Mar 2023, jabfm.2022.220204R2; DOI: 10.3122/jabfm.2022.220204R2
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Keywords

  • Caregivers
  • Chronic Disease
  • Cross-Sectional Studies
  • Delivery of Health Care
  • Heart Failure
  • Home Health Care
  • New York
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