Home Medical Equipment Use

Weaver FM, Hurder A, Hughes SL, Smith G, Kubal JD, Ulasevich A, Tir K. Home Medical Equipment Use. Paper presented at: Addiction Health Services Research Conference; 1997 Jun 15; Chicago, IL.

Since 1989, home health care expenditures have surpassed all other forms of personal health care expenditures, with an annual growth rate of 20%. Home medical equipment (HME) and related services are an integral component of the home health care system. Currently, there are over six thousand companies that sell and/or rent HME. Despite this growth, little is known about the kinds of patients that receive HME, or the types of HME they receive.This analysis is a part of a larger cooperative trail study of the cost-effectiveness of the Department of Veterans' Affairs (VA) Home Based Primary Care (HBPC) program. This multi-site trial includes 16 VA HBPC programs across the country. Patients who were severely disabled or terminally ill were recruited for the study. Subjects and their informal caregivers were randomized to either HBPC or customary care (i.e. any other post-acute services for which the patient was eligible other than HBPC). All health care utilization and costs for these subjects were monitored over a 12-month period.Home medical equipment use was abstracted form the VA's Prosthetics data base which monitors all HME prescribed to veterans by VA doctors. Data for approximately half of our projected study sample (those who have completed the study ) are presented. Over the 12-month study period, 83% of this sample (n = 859) received some type of HME. receipt of HME did not differ by diagnosis, age, gender, race or education. However a patient was more likely to receive HME if his/her caregiver was either a spouse or a child (84%) than when the caregiver was either another relative or non-relative (78%). Patients who were impaired in dressing, transferring or incontinent were significantly more likely to receive HME than patients who were not impaired (all p's < 0.03). These three functional status variables were able to correctly classify HME users 61.3% of the time.When only users were examined, the amount of HME used per person was substantial. The average user received 7.4 items over a 12-month period (sd = 6.8); disabled patients utilized more HME than terminal patients (means = 7.7v. 6.0). over 6,200 items were issued to this sample in the 12-month study period. The most frequently prescribed equipment included commodes/bath benches (9%), canes/crutches/walkers (7%), safety equipment (7%), liquid oxygen (6%), and orthotics (5%). Most HME was provided by HME vendors; equipment ordered was to replace existing equipment in the home; the majority of which was respiratory equipment. As Congress and policy makers begin to take a closer look at home health care use and reimbursement, it is important to have a good understanding of this substantial component of health care.