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[Differences between institutionalized patients and those included in a home care program in Seville]
Macarena Huesa Andrade1, José Luis Calvo-Gallego2, Miguel Ángel Pedregal González3
1Medicina Familiar y Comunitaria, Centro de salud de Camas, Sevilla, España.
Objectives:
To describe the characteristics and clinical differences between institutionalised patients and those included in a home care program.
Design:
A descriptive, observational, cross-sectional, and multicentre study. Site Seville, 2016.
Study Subjects:
A total 1857 elderly patients of similar characteristics (1441 institutionalised and 416 at home) in Seville in 2016.
Measurements:
The variables studied included gender, age, civil status, family support, pathologies, multiple pathology criteria, and medication prescriptions. Functional and cognitive status was evaluated using the Barthel index, and the Lawton-Brody and Pfeiffer scales.
Results:
The majority of patients (71.40%) were women. The fact of being institutionalised or being included in a home care program were statistically related to the following pathologies and categories: schizophrenia (p<.001), arterial hypertension (p=.012), diabetes mellitus (p=.001), atrial fibrillation (p<.001), and neoplasia (p=.012), A1 (p=.012), A2 (p<.001), B1 (p<.001), B2 (p=.002), C (p<.001), E1 (p<.001), E3 (p=.01), F2 (p<.01), G2 (p=.024), and H (p=.005). The mean Barthel index of the sample was 49.1±34.45 (95% confidence interval: 47.49-50.7). The mean Lawton-Brody scale in the case of patients included the home care program was 2.33±2.49 and in those institutionalised 1.59±2.12. The mean Pfeiffer scale was 4.93±3.53.
Conclusions:
Cognitive impairment was related to institutionalisation, being a result of possible neurological (E3 category) and psychiatric diseases. On the other hand, patient comorbidity was not related to it, because it is very high in patients included in a home care program, in whom functional and cognitive independency status is better.