From Hospital to Home and Back Again: A Study in Hospital Admissions and Deaths for Home Care Patients

Abstract

In this study, the authors examined causes of deaths or hospitalizations of adult home care patients during an 18-month period using a retrospective medical record audit. The site of the study was the home care program of a three-hospital system. Of 4,303 cases, 101 adult patients met study criteria of hospitalization or death. The death rate in the sample was 0.48%, and the hospitalization rate was 1.9%. Wound deterioration and falling accidents were principal causes for rehospitalizing patients. Increasing age and number of medications were significantly correlated with falls resulting in hospitalization. Patients who died were found to suffer from terminal illnesses and frailty, with care providers having little influence over outcomes. Opportunities to improve clinical care processes (e.g., discharge planning, patient status monitoring, signs and symptoms reporting, interdisciplinary communicating and coordinating) were also identified. The authors concluded that nearly 21% of hospitalizations were potentially preventable.

Medication errors in home care: a qualitative focus group study

“…), such as problems with nutrition, risk of falls or fall‐related injuries, nausea and vomiting, bleeding especially from the stomach or intestine, dizziness, delirium, stroke and need for hospital admission (Taft et al . , Hartikainen et al . , Zhang et al .…”

“…In addition, medication errors are ranked as the fourth to sixth cause of death in the USA (Hajjar et al 2007). In addition, the olderthose over 65 years of ageare at high risk for medication-related problems (Gusdal et al 2011, Olaniyan et al 2014, such as problems with nutrition, risk of falls or fall-related injuries, nausea and vomiting, bleeding especially from the stomach or intestine, dizziness, delirium, stroke and need for hospital admission (Taft et al 2005, Hartikainen et al 2007, Zhang et al 2007, Heuberger 2012, Davies & O'Mahony 2015.…”

Chronic pain with use of analgesics and mortality in the home healthcare elderly: a nationwide population-based study

“…A previous study revealed that an acute exacerbation of chronic disease is the most common reason for an unplanned hospitalization or ED visit, which can be prevented through knowledge of risk factors, provider communication, and careful monitoring [29]. Other risk factors are polypharmacy [30], the length of HHC episode [31], worsening primary or secondary diagnosis or the development of a new problem [32], falls [30], and advancing age [30]. Strategies recommended for preventing hospitalization or ED visit are patient/caregiver education, 24-hour on-call nursing coverage, telehealth, management support, case management, front loading visits, medication management, fall prevention program, and positive physician and hospital relationships [33].…”

Racial/Ethnic Disparities in Home Health Care: Charting a Course for Future Research

“…Agency policy/procedures associated with outcomes include: effective use of information technology or continuous quality improvement use, agency culture, use of action plans; and telemonitoring, staff education/training, and discharge planning (Burt & Pabin, 2006;Shaugnessy et al, 2002;Crossen-Sills, Toomey, & Doherty, 2006;Taft, 2005). Outcomes also differed depending on the type of payment (Shaughnessy, Schlenker, & Hittle, 1994).…”