[Factors associated with hospitalization in a cohort of elderly patients included in a home care program].
Med Clin (Barc) 2012;
139:473-8. [PMID:
22592080 DOI:
10.1016/j.medcli.2012.01.030]
[Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 12/21/2011] [Accepted: 01/03/2012] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE
The objective is to identify the features associated with next year hospital admissions among elderly dependent patients living at home (EDLH) and visited by primary care teams at their home setting.
PATIENTS AND METHOD
Longitudinal cohort study of a sample of EDLH patients admitted to a home care programme delivered by 72 primary care teams. A global health assessment was performed at recruitment in all patients (health and social status, informal and formal carer characteristics and burden of care). We further collected data on visits by primary care personnel and the use of social, emergency and hospital services by EDLH patients throughout one year after recruitment.
RESULTS
A sample of 1,093 EDLH patients was included. 258 (23,6%) patients were admitted to hospital during follow-up and 170 (15.6%) were lost to follow-up. Hospitalised patients received the same volume of primary care and social care services at home than those that were not hospitalised. Independent predictors of high risk of hospital admission were calling and using the after-hours emergency community services (odds ratio [OR]= 2.50, 95% confidence interval [95% CI] 1.56-4.01) and comorbidity as measured by the Charlson Index (OR= 1.16, 95% CI 1.06-1.27) at recruitment. Similarly, female sex (OR= 0.59, 95% CI 0.40-0.85) and high subjective physical health status scores as measured by the SF12 questionnaire (OR 0.97, 95% CI 0.95-0.99) predicted a low-risk of hospital admission.
CONCLUSIONS
Hospital admission among EDLH patients is related to comorbidity, gender, subjective health status and the use of uncoordinated emergency services as measured at recruitment, rather than to the use of services during the one-year follow-up.
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