Predictive factors for hospitalization in patients on integrated home care program

Area of Science:

• Gerontology
• Palliative Care
• Health Services Research

Background:

• Integrated Home Care (IHC) programs aim to provide comprehensive medical services to patients in their homes, reducing the need for hospital admissions.
• Identifying factors associated with hospitalization is crucial for optimizing IHC program effectiveness and patient outcomes.

Purpose of the Study:

• To identify individual, familial, and organizational factors associated with hospitalization in patients enrolled in an Integrated Home Care (IHC) program.
• To analyze the frequency and timing of emergency room (ER) visits and hospitalizations within the IHC program.

Main Methods:

• Retrospective observational study analyzing data from patients in the Ferrara province, Italy, within an IHC program in 2018.
• Collected personal, clinical, logistic data, and care characteristics. Extracted ER evaluations and hospitalizations for each IHC case.
• Applied multivariate longitudinal data analysis for recurring events to identify risk factors for hospitalization.

Main Results:

• Multivariate analysis revealed that older age, male sex, parenteral nutrition, pressure sores, and advanced palliative care (oncologic and non-oncologic) were significantly associated with increased hospitalization risk.
• A total of 1512 hospitalizations occurred, with daytime ER access being threefold more frequent than nighttime access.
• ER admissions showed a regular distribution from Monday to Saturday, with a decrease on Sundays.

Conclusions:

• Specific patient conditions, including advanced palliative care needs and the presence of pressure sores, significantly impact hospitalization risk in IHC programs.
• This evidence suggests a need to reallocate resources to better manage these high-risk conditions and enhance home-based care delivery.