What are the factors that cause emergency home visit in home medical care in Japan?

Kuroda, Kishio; Miura, Taro; Kuroiwa, Shota; Kuroda, Moe; Kobayashi, N.; Kita, Keiichiro

doi:10.1002/jgf2.389

Cited by 7 publications

(21 citation statements)

References 19 publications

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“…We revealed that a cancer‐bearing state is a risk factor for emergency home visits through the multivariate Cox regression analysis (hazard ratio, 4.71; 95% CI, 2.60 to 8.52). The result is different from the finding of the study of Kuroda et al 9 Their analyses did not include each case's follow‐up period. They could have underestimated the cancer status's statistical weight because cancer patients usually have shorter survival than noncancer patients.…”

Section: Discussioncontrasting

confidence: 82%

“…First, our results could lack the representativity of institutions providing home care in Japan because we recruited only three clinics. Although patient characteristics were similar to those in studies of Japanese home care patients, 8,9 physician and family characteristics could affect emergency home visits. Second, the participants of this study did not include patients living in nursing homes due to severe dementia because we were unable to obtain informed consent from those patients.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 62%

“…It was similar to the mean age of 82.2 and 82.8 years in recent studies conducted in Japan. 8 , 9 Kaneko et al 8 reported that the mean age of the patients receiving home visits in Japan was higher than that in the UK 15 and Australia. 16 The difference may be caused by Japan's policy promoting home care for older adults 4 and, as Ishida et al 17 suggested, inequitable access to appropriate healthcare resources among the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

“…We found that our cohort had no central venous port users during the study period, although we usually provide home visits to those patients. Kuroda et al 9 reported that the level of care needed and urinary catheter use affected the emergency home visits for mainly fever management, yet we did not measure those factors. According to our clinical experience, fever is not a significant reason for emergency home visits among cancer patients.…”

Section: Methodsmentioning

confidence: 99%

“…Although there is Japanese evidence that home visits for cancer patients are cost‐saving 6 and can achieve good death 7 than hospital care, there is scarce research on the frequency of emergency home visits. Kaneko et al 8 and Kuroda et al 9 investigated the reason for and the factor of emergency home visits for cancer patients, respectively, but the incidence has not yet been investigated. Furthermore, the results that a cancer‐bearing state was not associated with the frequency of emergency home visits should be reexamined.…”

Section: Introductionmentioning

confidence: 99%

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Prospective cohort study on the incidence and risk factors of emergency home visits among Japanese home care patients

Kato

Tomita²,

Kato

et al. 2021

J of Gen and Family Med

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Patient-centered care has been gaining greater attention in the discussion of quality. 1 As for patient-centered care for cancer patients, a population-based survey conducted in European countries revealed that home care is a valuable way to achieve it, especially in terminal stages. 2 As Tralongo et al. argued, the cancer patient-centered home care framework aims at several targets: enhanced patient-physician relationship; coordinated, comprehensive, and accessible care; and assured quality and safety. 3 In line with this international trend, Japan's Ministry of Health, Labour and Welfare has promoted physician home visits to provide better patient-centered care and end-of-life care in their familiar place to live. 4

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Section: Discussioncontrasting

confidence: 82%

Section: Strengths and Limitations Of This Studymentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prospective cohort study on the incidence and risk factors of emergency home visits among Japanese home care patients

Kato

Tomita²,

Kato

et al. 2021

J of Gen and Family Med

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Author reply to “Cancer causes emergency home visits”

Kuroda

Miura²,

Kuroiwa

et al. 2021

J of Gen and Family Med

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Hybrid emergency care at the home for patients – A multiple case study

Falchenberg,

Andersson,

Boysen

et al. 2024

BMC Emerg Med

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Introduction Healthcare systems worldwide are facing numerous challenges, such as an aging population, reduced availability of hospital beds, staff reductions and closure of emergency departments (ED). These issues can exacerbate crowding and boarding problems in the ED, negatively impacting patient safety and the work environment. In Sweden a hybrid of prehospital and intrahospital emergency care has been established, referred to in this article as Medical Emergency Team (MET), to meet the increasing demand for emergency care. MET, consisting of physicians and nurses, moving emergency care from EDs to patients’ home. Physicians and nurses may encounter challenges in their healthcare work, such as limited resources for example medical equipment, sampling and examination, in unfamiliar varying home environments. There is a lack of knowledge about how these challenges can influence patient care. Therefore, the aim of this study was to explore the healthcare work of the METs when addressing patients’ emergency care needs in their homes, with a focus on the METs reasoning and actions. Methods Using a qualitative multiple case study design, two METs in southwestern Sweden were explored. Data were collected from September 2023 – January 2024 and consist of field notes from participant observations, short interviews and written reflections. A qualitative manifest content analysis with an inductive approach was used as the analysis method. Result The result of this study indicates that physicians and nurses face several challenges in their daily work, such as recurring interruptions, miscommunication and faltering teamwork. Some of these problems may arise because physicians and nurses are not accustomed to working together as a team in a different care context. These challenges can lead to stress, which ultimately can expose patients to unnecessary risks. Conclusion When launching a new service like METs, which is a hybrid of prehospital and intrahospital emergency care, it is essential to plan and prepare thoroughly to effectively address the challenges and obstacles that may arise. One way to prepare is through team training. Team training can help reduce hierarchical structures by enabling physicians and nurses to feel that they can contribute, collaborate, and take responsibility, leading to a more dynamic and efficient work environment.

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What are the factors that cause emergency home visit in home medical care in Japan?

Cited by 7 publications

References 19 publications

Prospective cohort study on the incidence and risk factors of emergency home visits among Japanese home care patients

Prospective cohort study on the incidence and risk factors of emergency home visits among Japanese home care patients

Author reply to “Cancer causes emergency home visits”

Hybrid emergency care at the home for patients – A multiple case study

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