Medicare's national home health assessment (OASIS) gathers data on client depression status but there are no studies to determine whether evidence-based depression care is provided to clients. The research question is: Do Medicare home health agencies provide evidence-based depression interventions to clients assessed with depression ?
212 randomly selected Medicare home health patients from one home health agency were followed during their periods of care in 2017, with periods of care varying from 30 days to 183 days. Data collected included copies of all applicable OASIS forms; copies of all plans of treatment & provider notes; & administration of a PHQ-9 at first home visit and every 15 days thereafter.
193 of the sample clients had depression indicated on their initial OASIS as an assessed need. 95% of the 193 clients (183 clients) had their PHQ-9 level increase during their period of care. 90% of these clients (165 clients) received no intervention for depression.
Conclusions & Implications:
The study concludes that study sample illustrates Medicare home health agency not providing evidence-based depression care to clients with assessed needs for depression care. The research implication is the need for more expansive studies to determine whether the results have external validity. The policy and practice implications point to a possible need to revise the Medicare home health law and regulations to require allowing such evidence-based depression care.