Reasons for home care clients' unplanned Hospital admissions and their associations with patient characteristics

Reasons for home care clients' unplanned Hospital admissions and their associations with patient characteristics

Author:
Publication type: 
Journal Article
Year: 
2018
Journal/Series title: 
Arch Gerontol Geriatr
Volume number: 
78
Pages: 
114-126
ISSN/ISBN: 
0167-4943
Abstract: 

BACKGROUND: Unplanned hospitalizations and emergency room visits occur frequently among home care clients The aim of this study was to identify typical discharge diagnoses and their associations with patient characteristics among a total of 6812 Finnish home care clients aged >/=63 years who were hospitalized within one year of their first home care assessment. METHODS: A register-based study based on Resident Assessment Instrument-Home Care (RAI-HC) assessments and nationwide hospital discharge records. The RAI-HC assessments were linked to the hospital discharge records of the participants' first unplanned hospitalization. Univariate and multivariable regression analyses were used to evaluate the association of RAI-HC determinants with discharge diagnoses. RESULTS: The most common reason for the first hospitalization was an infectious disease (21%; n=1446). When hospitalizations were classified according to the main diagnosis, chronic skin ulcers, functional impairment and daily urinary incontinence were associated with hospitalization due to infectious diseases; impaired cognitive capacity, Alzheimer's disease or other dementia and polypharmacy (protective effect) were associated with hospitalizations due to dementia; age of >/=90 years, congestive heart failure, coronary artery disease and using >/=10 drugs with hospitalizations due to heart diseases; and moderate or strong pain with hospitalization due to musculoskeletal disorders. Previous falls, female sex and an earlier hip fracture were associated with injury-related hospitalizations. Feelings of loneliness increased the odds of hospitalization due to geriatric symptoms without a specific diagnosis. CONCLUSION: Patient characteristics and geriatric syndromes identified using RAI-HC predict the reasons for future hospitalizations among new home care clients.