Older adults who receive homecare are at increased risk of readmission and mortality following a short ED admission: a nationally register-based cohort study
Abstract Background Older adults admitted to an emergency department (ED) who are dependent on homecare may be especially challenged with respect to readmission and mortality. This study aimed to assess whether receiving homecare prior admission was associated with readmission or mortality within 30...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-021-02644-6 |
| _version_ | 1798026788207591424 |
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| author | Mette Elkjær Donna Lykke Wolff Jette Primdahl Christian Backer Mogensen Mikkel Brabrand Bibi Gram |
| author_facet | Mette Elkjær Donna Lykke Wolff Jette Primdahl Christian Backer Mogensen Mikkel Brabrand Bibi Gram |
| author_sort | Mette Elkjær |
| collection | DOAJ |
| description | Abstract Background Older adults admitted to an emergency department (ED) who are dependent on homecare may be especially challenged with respect to readmission and mortality. This study aimed to assess whether receiving homecare prior admission was associated with readmission or mortality within 30 days of a short ED admission and to explore whether the amount of homecare received was associated with an increased risk of readmission or mortality. Methods This nationwide register-based cohort study included patients aged 65 or above who were admitted to an ED at any Danish hospital from 1 December 2016 to 30 November 2017 and discharged within 48 h. Data were extracted from national registers through Statistics Denmark. Homecare was categorized into groups; patients without homecare and three groups according to the amount of homecare received per week. Logistic regression analyses were used to explore the association between the four homecare groups and outcomes, readmissions and mortality. Results In total, 80,517 patients (51% female, median age 75 years) were included in the study. Overall, 64,886 patients without homecare, 15,631 (19%) patients received homecare (64% female, median age 83 years), of which 4938 patients received homecare ≤30 min, 4033 received > 30 min to ≤120 min and 6660 received > 120 min per week. The risk of readmission and mortality increased concurrently with the minutes of homecare received: Patients receiving homecare > 120 min per week had the highest odds ratios (ORs) for readmission within 30 days (OR 1.8 95% CI: 1.7–1.9) and mortality within 30 days (OR 4.5 95% CI: 4.1–4.9) compared with patients without homecare. Conclusion Receiving homecare was associated with an increased risk of readmission and death following a short ED admission. Collaboration between the ED and primary health care sector in relation to rehabilitation and end-of-life care is essential to improve quality of care for older adults who receive homecare, particularly those receiving homecare > 2 h a week, because of their increased risk of readmission and mortality. |
| first_indexed | 2024-04-11T18:40:59Z |
| format | Article |
| id | doaj.art-a88e657607724a999a72b1943c60d023 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-11T18:40:59Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-a88e657607724a999a72b1943c60d0232022-12-22T04:08:58ZengBMCBMC Geriatrics1471-23182021-12-012111910.1186/s12877-021-02644-6Older adults who receive homecare are at increased risk of readmission and mortality following a short ED admission: a nationally register-based cohort studyMette Elkjær0Donna Lykke Wolff1Jette Primdahl2Christian Backer Mogensen3Mikkel Brabrand4Bibi Gram5Department of Emergency Medicine, University hospital of Southern DenmarkDepartment of Regional Health Research, University of Southern DenmarkDepartment of Regional Health Research, University of Southern DenmarkDepartment of Emergency Medicine, University hospital of Southern DenmarkDepartment of Regional Health Research, University of Southern DenmarkDepartment of Regional Health Research, University of Southern DenmarkAbstract Background Older adults admitted to an emergency department (ED) who are dependent on homecare may be especially challenged with respect to readmission and mortality. This study aimed to assess whether receiving homecare prior admission was associated with readmission or mortality within 30 days of a short ED admission and to explore whether the amount of homecare received was associated with an increased risk of readmission or mortality. Methods This nationwide register-based cohort study included patients aged 65 or above who were admitted to an ED at any Danish hospital from 1 December 2016 to 30 November 2017 and discharged within 48 h. Data were extracted from national registers through Statistics Denmark. Homecare was categorized into groups; patients without homecare and three groups according to the amount of homecare received per week. Logistic regression analyses were used to explore the association between the four homecare groups and outcomes, readmissions and mortality. Results In total, 80,517 patients (51% female, median age 75 years) were included in the study. Overall, 64,886 patients without homecare, 15,631 (19%) patients received homecare (64% female, median age 83 years), of which 4938 patients received homecare ≤30 min, 4033 received > 30 min to ≤120 min and 6660 received > 120 min per week. The risk of readmission and mortality increased concurrently with the minutes of homecare received: Patients receiving homecare > 120 min per week had the highest odds ratios (ORs) for readmission within 30 days (OR 1.8 95% CI: 1.7–1.9) and mortality within 30 days (OR 4.5 95% CI: 4.1–4.9) compared with patients without homecare. Conclusion Receiving homecare was associated with an increased risk of readmission and death following a short ED admission. Collaboration between the ED and primary health care sector in relation to rehabilitation and end-of-life care is essential to improve quality of care for older adults who receive homecare, particularly those receiving homecare > 2 h a week, because of their increased risk of readmission and mortality.https://doi.org/10.1186/s12877-021-02644-6Primary health careOlder adultsDeathAcute illnessAcute hospitalisationMultimorbidity |
| spellingShingle | Mette Elkjær Donna Lykke Wolff Jette Primdahl Christian Backer Mogensen Mikkel Brabrand Bibi Gram Older adults who receive homecare are at increased risk of readmission and mortality following a short ED admission: a nationally register-based cohort study BMC Geriatrics Primary health care Older adults Death Acute illness Acute hospitalisation Multimorbidity |
| title | Older adults who receive homecare are at increased risk of readmission and mortality following a short ED admission: a nationally register-based cohort study |
| title_full | Older adults who receive homecare are at increased risk of readmission and mortality following a short ED admission: a nationally register-based cohort study |
| title_fullStr | Older adults who receive homecare are at increased risk of readmission and mortality following a short ED admission: a nationally register-based cohort study |
| title_full_unstemmed | Older adults who receive homecare are at increased risk of readmission and mortality following a short ED admission: a nationally register-based cohort study |
| title_short | Older adults who receive homecare are at increased risk of readmission and mortality following a short ED admission: a nationally register-based cohort study |
| title_sort | older adults who receive homecare are at increased risk of readmission and mortality following a short ed admission a nationally register based cohort study |
| topic | Primary health care Older adults Death Acute illness Acute hospitalisation Multimorbidity |
| url | https://doi.org/10.1186/s12877-021-02644-6 |
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