Factores asociados a ingreso hospitalario en una cohorte de pacientes ancianos incorporados a un programa de atención domiciliaria

Badía, Joan Gené; Santos, Alícia Borràs; Segura, Joan Carles Contel; Terén, Carlos Ascaso; Ortega, María González; Gallo, Pedro

doi:10.1016/j.medcli.2012.01.030

Cited by 10 publications

(4 citation statements)

References 20 publications

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“…Previous research with the same cohort has found that hospital admissions are related to lack of coordination among services as well as demand induced by family relatives and patients themselves [6]. …”

Section: Discussionmentioning

confidence: 99%

“…The methodology of the study has been published elsewhere [6,18]. This study was conducted in Catalonia, a region in Spain with a National Health Service that provides health care to every citizen free of charge at the point of delivery.…”

Section: Methodsmentioning

confidence: 99%

“…A research team member audited and validated 10% of the data gathered by collaborative researchers from patients’ original clinical records. The Kappa index and interclass correlation index were used to test the concordance among registers [6]. The results showed an adequate concordance.…”

Section: Methodsmentioning

confidence: 99%

“…In this respect, previous published studies have identified comorbidity, discontinuity of care, demand and social problems as major causes of hospital admissions among EDPLH patients benefitting from home care programmes [5,6]. Further, it is known that pressure ulcers are a major predictor of death in patients living at home or in nursing homes.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of mortality among elderly dependent home care patients

Badía

Santos

Segura

et al. 2013

BMC Health Serv Res

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BackgroundThe purpose of this study is to identify which variables –among those commonly available and used in the primary care setting– best predict mortality in a cohort of elderly dependent patients living at home (EDPLH) that were included in a home care program provided by Primary Care Teams (PCT). Additionally, we explored the risk of death among a sub-group of these patients that were admitted to hospital the year before they entered the home care program.MethodsA one-year longitudinal cohort study of a sample of EDPLH patients included in a home care programme provided by 72 PCTs. Variables collected from each individual patient included health and social status, carer’s characteristics, carer’s burden of care, health and social services received.Results1,001 patients completed the study (91.5%), 226 were admitted to hospital the year before inclusion. 290 (28.9%) died during the one-year follow-up period. In the logistic regression analysis women show a lower risk of death [OR= 0.67 (0.50-0.91)]. The risk of death increases with comorbidity [Charlson index OR= 1.14 (1,06-1.23)], the number of previous hospital admissions [OR= 1,16 (1.03-1.33)], and with the degree of pressure ulcers [ulcers degree 1–2 OR = 2.94 (1.92-4.52); ulcers degree 3–4 OR = 4.45 (1.90-10.92)]. The logistic predictive model of mortality for patients previously admitted to hospital identified male sex, comorbidity, degree of pressure ulcers, and having received home care rehabilitation as independent variables that predict death.ConclusionsComorbidity, hospital admissions and pressure ulcers predict mortality in the following year in EDPLH patients. The subgroup of patients that entered home care programs with a previous record of hospital admission and a high score in our predictive model might be considered as candidates for palliative care.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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