Patient Outcomes Improve Under Single Home Health Aides

Individuals receiving home health services stand to experience better outcomes if cared for by the same aide day in and day out, according to a recent study by SAGE Publications. 

Patients who see the same home health aide across a series of visits have a higher likelihood of improving in various activities of daily living (ADLs) compared to patients whose care is provided by multiple aides, according to the study Continuity in the Provider of Home Health Aide Services and the Likelihood of Patient Improvement in Activities of Daily Living

Based on cases from the Visiting Nurse Service of New York (VNSNY)—a large, urban, non-profit Medicare certified home health agency—the study found that individuals who were cared for continuously by the same aide had a 93% chance of improving their ADLs. 


Those who experienced low-continuity of care—meaning care was spread out among various aides over the course of a home health service period—were approximately 14%-15% less likely to improve their ADLs between home health admission and discharge than individuals who were always visited by the same aide.

Also of note in the report, cases where patients had moderate-continuity did not significantly differ from higher continuity cases in their likelihood of ADL improvement. 

Although a majority of cases in the study’s population improved in the number and severity of ADLs between admission and discharge, researchers note that the odds of improvement among cases with high continuity are greater than those for low continuity.


“Ideally, patients should receive services from a single aide over the entire period of home care,” writes the study’s lead author David Russell, Ph.D, Center for Home Care Policy & Research at VNSNY. “However, a number of staffing constraints and operational obstacles often present a challenge to achieving this goal.”

Home health agencies often provide around-the-clock care and have several staff to cover different shifts, but sometimes these staff members carry multiple case loads and have limited time for care planning, monitoring and review, says Russell.

One strategy to combat this, according to the report, could be to use primary provider teams in conjunction with backup provider teams to limit the number of aides who visit a patient. 

A second strategy the study proposes is to focus on reducing the number of cases with low levels of continuity, and work to improve this group to a more moderate level. 

Although the study was based on one non-profit Medicare-certified home health agency, the findings build upon extensive research that suggests a continuity in the relationship between a patient and his or her caregiver increases the odds of positive patient outcomes.

View an abstract of the report.

Written by Jason Oliva

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