Linkage of social care and hospital admissions data to explore non-delivery of planned home care for older people in Scotland

Abstract

Purpose As part of a pilot studyassessing the feasibility of record-linking health and social care data, the purpose of this paper is to examine patterns of non-delivery of home care among older clients (>65 years) of a social home care provider in Glasgow, Scotland. The paper also assesses whether non-delivery is associated with subsequent emergency hospital admission. Design/methodology/approach After obtaining appropriate permissions, the electronic records of all home care clients were linked to a hospital inpatient database and anonymised. Data on home care plans were collated for 4,815 older non-hospitalised clients, and non-delivered visits were examined. Using case-control methodology, those who had an emergency hospital admission in the next calendar month were identified (n=586), along with age and sex-matched controls, to determine whether non-delivery was a risk factor for hospital admission. Findings There were 4,170 instances of “No Access” non-delivery among 1,411 people, and 960 instances of “Service Refusal” non-delivery among 427 people. The median number of undelivered visits was two among the one-third of clients who did not receive all their planned care. There were independent associations between being male and living alone, and non-delivery, while increasing age was associated with a decreased likelihood of non-delivery. Having any undelivered home care was associated with an increased risk of emergency hospital admission, but this could be due to uncontrolled confounding. Research limitations/implications This study demonstrates untapped potential for innovative research into the quality of social care and effects on health outcomes. Originality/value Non-delivery of planned home care, for whatever reason, is associated with emergency hospital admission; this could be a useful indicator of vulnerable clients needing increased surveillance.

Evde Sağlık Hizmeti Alan Hastaların Acil Servise Başvuru Nedenlerinin İncelenmesi

“…bulunmamıştır(16). Ancak İskoçya'da yapılan vaka -kontrol çalışmasında lojistik regresyon analizinde evde sağlık hizmetinin sağlanmamasının acil hastaneye kabulün bir risk faktörü olduğu bildirilmiştir(24). Küresel olarak, yaşlı insanların planlanmamış hastane kabulleri ile yüksek oranda acil servisi kullandıkları ve acil tıbbi hizmet aldıkları yapılan çalışmalarda bulunmuştur(25)(26)(27)(28).…”