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BMC Health Services Research

, 13:316

Healthcare needs and demand

Abstract

BackgroundThe purpose of this study is to identify which variables –among those commonly available and used in the primary care setting– best predict mortality in a cohort of elderly dependent patients living at home EDPLH that were included in a home care program provided by Primary Care Teams PCT. Additionally, we explored the risk of death among a sub-group of these patients that were admitted to hospital the year before they entered the home care program.

MethodsA one-year longitudinal cohort study of a sample of EDPLH patients included in a home care programme provided by 72 PCTs. Variables collected from each individual patient included health and social status, carer’s characteristics, carer’s burden of care, health and social services received.

Results1,001 patients completed the study 91.5%, 226 were admitted to hospital the year before inclusion. 290 28.9% died during the one-year follow-up period. In the logistic regression analysis women show a lower risk of death OR= 0.67 0.50-0.91. The risk of death increases with comorbidity Charlson index OR= 1.14 1,06-1.23, the number of previous hospital admissions OR= 1,16 1.03-1.33, and with the degree of pressure ulcers ulcers degree 1–2 OR = 2.94 1.92-4.52; ulcers degree 3–4 OR = 4.45 1.90-10.92. The logistic predictive model of mortality for patients previously admitted to hospital identified male sex, comorbidity, degree of pressure ulcers, and having received home care rehabilitation as independent variables that predict death.

ConclusionsComorbidity, hospital admissions and pressure ulcers predict mortality in the following year in EDPLH patients. The subgroup of patients that entered home care programs with a previous record of hospital admission and a high score in our predictive model might be considered as candidates for palliative care.

KeywordsPrimary care Home care Elderly patients Dependency Mortality AbbreviationsEDPLHElderly dependent patients living at home

PCTPrimary care teams

SF-12The short form 12 Health Survey is a survey of patient health

OROdds ratio

CIConfidence interval.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-13-316 contains supplementary material, which is available to authorized users.

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Autor: Joan Gené Badia - Alícia Borràs Santos - Joan Carles Contel Segura - Carlos Ascaso Terén - Laura Corredoira Gonzál

Fuente: https://link.springer.com/







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