Applying home time to examine outcomes for people living with dementia after emergency care

Clinicians, investigators, and policymakers have all recognized the need to develop patient-centered outcome measures to better evaluate health care quality and clinical interventions. Home time has emerged as one promising measure, along with similar survival-residence composite outcomes, such as hospital-free days. One strength of these measures is that they can be collected pragmatically, using administrative data. The patient-centeredness of home time, particularly for persons living with dementia (PLWD), is supported by evidence that these individuals prefer to age in place and avoid unnecessary institutionalization or hospitalization. Optimizing home time for PLWD is a national priority, given the accelerating costs and long-term care needs for this population. However, there are outstanding questions about how to define home time as well as for which clinical scenarios its measurement is appropriate.

Catherine L Auriemma, Austin S Kilaru