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Predictors of mortality among elderly dependent home care patients
- Source :
- Dipòsit Digital de la UB, Universidad de Barcelona, Recercat. Dipósit de la Recerca de Catalunya, instname, BMC Health Services Research
- Publication Year :
- 2013
- Publisher :
- Springer Science and Business Media LLC, 2013.
-
Abstract
- Background The 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. Methods A 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. Results 1,001 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. Conclusions Comorbidity, 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.
- Subjects :
- Male
Social Work
medicine.medical_specialty
Palliative care
Health Status
Dependency
Comorbidity
Logistic regression
Lower risk
Severity of Illness Index
Home care
Health administration
Sex Factors
Cost of Illness
Risk Factors
Severity of illness
Mortalitat
medicine
Humans
Longitudinal Studies
Mortality
Intensive care medicine
Aged, 80 and over
Pressure Ulcer
Models, Statistical
business.industry
Persones grans dependents
Health Policy
Public health
Cuidadors
Health Services
Primary care
medicine.disease
Home Care Services
Frail elderly
Elderly patients
Hospitalization
Social Class
Caregivers
Emergency medicine
Cohort
Female
business
Research Article
Subjects
Details
- ISSN :
- 14726963
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....eb63215b637abd7399f5397958726d95