Occupational therapy and home health care.

This special issue of The American Journal of Occupational Therapy (AJOT) is devoted to the issues of home health care. Although the importance of the home environment in the treatment of illness has been well known, its importance has now been formalized by third-party payers for home health care services. Between 1974 and 1982, Medicare program payments for home health services increased 965.5%. Total Medicare expenditures increased only 296.8% in Michael). Steinhauer, OTR, lVIPH, the same period. Increased use is Administrator, El Dorado Home was demonstrated by a 246.9% Health Inc., 2405 West North rise In home health visits (1). Avenue, Chicago, IL 60647. He is a With the implementation of the graduate of both Tufts UniversityProspective Payment System Boston School of Occupatwnal within hospitals, it is anticipated Therapy and Northwestern University that there will be greater need Medical School-Graduate School in for home health services because Public Health. Before his present patients may be discharged position, he sjJent several years 111 sooner than in the past. There is clznical practice in home healthlittle doubt that the trend will be del1Vered occupational therapy m toward more home-delivered serBoston and Chicago. He is actzve in vices; this will result in an impact both state and national public health on health professions. and home health services organizations, and is a ji-equent guest speaker The Impact on Occupational at conferences and seminars. Therapy The impact on occupational percentage of COTAs in home therapy has already been demonhealth has grown from 0.2% to strated. The American Occupa0.8%. According to Carolyn tional Therapy Association Baum at a speech given at an Illi(AOTA) member data survey for nois Occupational Therapy Asso1982 (2) shows that the number cia tion meeting A prj] 6, 1984 in of registered occupational theraCollinsville, IL, there are no stapists that list home health agentistics to define the number of cies as a primary employment sethospital-based home care occupating increased from 0.9% to tional therapists; however, it is 3.8%. Although the increase in anticipated that there will be an the number of certified occupaincrease in those numbers as well. tional therapy assistants (COTAs) Although some occupational has been somewhat slower, the therapy personnel have treated patients in their homes from the profession's beginning, this type of treatment has not been the main focus of practice, which traditionally has been institutionally based. Although home nursing care has been well established, especially through the Visiting Nurse Associations, only recently, with the advent of third-party payers to support home health care, have occupational therapy personnel begun to develop practice in this area.