{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T10:55:29Z","timestamp":1774436129675,"version":"3.50.1"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Home health care (HHC) has been increasingly used to improve care transitions and avoid poor outcomes, but there is limited data on its use and efficacy following coronary artery bypass grafting. The purpose of this study was to describe HHC use and its association with outcomes among Medicare beneficiaries undergoing coronary artery bypass grafting.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Retrospective analysis of 100% of Medicare fee-for-service files identified 77\u2005331 beneficiaries undergoing coronary artery bypass grafting and discharged to home between July 2016 and December 2018. The primary exposure of HHC use was defined as the presence of paid HHC claims within 30 days of discharge. Hierarchical logistic regression identified predictors of HHC use and the percentage of variation in HHC use attributed to the hospital. Propensity-matched logistic regression compared mortality, readmissions, emergency department visits, and cardiac rehabilitation enrollment at 30 and 90 days after discharge between HHC users and nonusers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>A total of 26\u2005751 (34.6%) of beneficiaries used HHC within 30 days of discharge, which was more common among beneficiaries who were older (72.9 versus 72.5 years), male (79.4% versus 77.4%), White (90.2% versus 89.2%), and not Medicare-Medicaid dual eligible (6.7% versus 8.8%). The median hospital\u2013level rate of HHC use was 31.0% (interquartile range, 13.7%\u201354.5%) and ranged from 0% to 94.2%. Nearly 30% of the interhospital variation in HHC use was attributed to the discharging hospital (intraclass correlation coefficient, 0.296 [95% CI, 0.275\u20130.318]). Compared with non-HHC users, those using HHC were less likely to have a readmission or emergency department visit, were more likely to enroll in cardiac rehabilitation, and had modestly higher mortality within 30 or 90 days of discharge.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>A third of Medicare beneficiaries undergoing coronary artery bypass grafting used HHC within 30 days of discharge, with wide interhospital variation in use and mixed associations with clinical outcomes and health care utilization.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.123.010459","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T09:00:33Z","timestamp":1716282033000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Home Health Care Use and Outcomes After Coronary Artery Bypass Grafting Among Medicare Beneficiaries"],"prefix":"10.1161","volume":"17","author":[{"given":"Michael P.","family":"Thompson","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery (M.P.T., H.H., D.S.L., F.D.P.), University of Michigan, Ann Arbor."},{"name":"Center for Healthcare Outcomes and Policy (M.P.T., D.S.L.), University of Michigan, Ann Arbor."},{"name":"Institute for Healthcare Policy and Innovation (M.P.T., D.S.L., F.D.P.), University of Michigan, Ann Arbor."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0890-0746","authenticated-orcid":true,"given":"Hechuan","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery (M.P.T., H.H., D.S.L., F.D.P.), University of Michigan, Ann Arbor."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0416-9359","authenticated-orcid":true,"given":"Donald S.","family":"Likosky","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery (M.P.T., H.H., D.S.L., F.D.P.), University of Michigan, Ann Arbor."},{"name":"Center for Healthcare Outcomes and Policy (M.P.T., D.S.L.), University of Michigan, Ann Arbor."},{"name":"Institute for Healthcare Policy and Innovation (M.P.T., D.S.L., F.D.P.), University of Michigan, Ann Arbor."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4430-9969","authenticated-orcid":true,"given":"Francis D.","family":"Pagani","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery (M.P.T., H.H., D.S.L., F.D.P.), University of Michigan, Ann Arbor."},{"name":"Institute for Healthcare Policy and Innovation (M.P.T., D.S.L., F.D.P.), University of Michigan, Ann Arbor."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason R.","family":"Falvey","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Rehabilitation Science and Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore (J.F.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7740-5725","authenticated-orcid":true,"given":"Kathryn H.","family":"Bowles","sequence":"additional","affiliation":[{"name":"Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia (K.H.B.)."},{"name":"Center for Home Care Policy &amp; Research, VNS Health, New York, NY (K.H.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1089-3896","authenticated-orcid":true,"given":"Rishi K.","family":"Wadhera","sequence":"additional","affiliation":[{"name":"Richard A. and Susan F. 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