Home care patients in four Nordic capitals – predictors of nursing home admission during one-year followup

The aim was to predict nursing home admission (NHA) for home care patients after a 12-month follow-up study. This Nordic study is derived from the aged in home care (AdHOC) project conducted in 2001–2003 with patients at 11 sites in Europe. The participants in the cohort study were randomly selected individuals, aged 65 years or older, receiving homecare in Oslo, Stockholm, Copenhagen, and Reykjavik. The Resident Assessment Instrument for Home Care (version 2.0) was used. Epidemiological and medical characteristics of patients and service utilization were recorded for 1508 home care patients (participation rate 74%). In this sample 75% were female. The mean age was 82.1 (6.9) years for men and 84.0 (6.6) for women. The most consistent predictor of NHA was receiving skilled nursing procedures at baseline (help with medication and injections, administration or help with oxygen, intravenous, catheter and stoma care, wounds and skin care) (adjusted odds ratio = 3.7, 95% confidence interval: 1.7–7.8; P < 0.001). In this Nordic material, stronger emphasizing on higher qualified nurses in a home care setting could prevent or delay NHA.

[1]  M. Trabucchi,et al.  Outcomes at 12 months in a population of elderly patients discharged from a rehabilitation unit. , 2008, Journal of the American Medical Directors Association.

[2]  Douglas G Altman,et al.  Dichotomizing continuous predictors in multiple regression: a bad idea , 2006, Statistics in medicine.

[3]  A. Tsouros,et al.  Home Care in Europe: The Solid Facts , 2009 .

[4]  M. Thorslund,et al.  Dementia and Depressive Symptoms as Predictors of Home Help Utilization Among the Oldest Old , 2004, Journal of aging and health.

[5]  M. Schroll,et al.  Community care in Europe. The Aged in HOme Care project (AdHOC) , 2004, Aging clinical and experimental research.

[6]  Cordula Wagner,et al.  Proposal of a service delivery integration index of home care for older persons: application in several European cities , 2006, International journal of integrated care.

[7]  E. Bradley,et al.  Expanding the Andersen model: the role of psychosocial factors in long-term care use. , 2002, Health services research.

[8]  F. D. Wolinsky,et al.  Reported expectations for nursing home placement among older adults and their role as risk factors for nursing home admissions. , 2006, The Gerontologist.

[9]  N. Ikegami,et al.  Comprehensive Clinical Assessment in Community Setting: Applicability of the MDS‐HC , 1997, Journal of the American Geriatrics Society.

[10]  J. Cohen-Mansfield,et al.  The Reasons for Nursing Home Entry in an Adult Day Care Population: Caregiver Reports Versus Regression Results , 2009, Journal of geriatric psychiatry and neurology.

[11]  Michael A Babyak,et al.  What You See May Not Be What You Get: A Brief, Nontechnical Introduction to Overfitting in Regression-Type Models , 2004, Psychosomatic medicine.

[12]  J. Pacolet,et al.  Social protection for dependency in old age , 1994 .

[13]  Jean F Wyman,et al.  Predictors of Nursing Home Admission for Persons with Dementia , 2009, Medical care.

[14]  P. Sloane,et al.  Validation of the Minimum Data Set Cognitive Performance Scale: agreement with the Mini-Mental State Examination. , 1995, The journals of gerontology. Series A, Biological sciences and medical sciences.

[15]  V. D. Hsu,et al.  Validation of a method for identifying nursing home admissions using administrative claims , 2007, BMC Health Services Research.

[16]  Y. Friedlander,et al.  Delaying Dementia and Nursing Home Placement , 2007, Annals of the New York Academy of Sciences.

[17]  S. O. Daatland,et al.  Ageing, intergenerational relations, care systems and quality of life - an introduction to the OASIS project , 2001 .

[18]  E. Porter.  Older Widows' Experience of Home Care , 2005, Nursing research.

[19]  G. Onder,et al.  Impact of a New Assessment System, the MDS‐HC, on Function and Hospitalization of Homebound Older People: A Controlled Clinical Trial , 2001, Journal of the American Geriatrics Society.

[20]  Marta Szebehely.  Äldreomsorgsforskning i Norden : En kunskapsöversikt , 2005 .

[21]  J. Hirdes,et al.  The Method for Assigning Priority Levels (MAPLe): A new decision-support system for allocating home care resources , 2008, BMC medicine.

[22]  P. Jonsson,et al.  Shaping home care in Europe: the contribution of the Aged in Home Care project. , 2009, Maturitas.

[23]  S. Kreiner,et al.  Self-rated general health among 40-year-old Danes and its association with all-cause mortality at 10-, 20-, and 29 years' follow-up , 2008, Scandinavian journal of public health.

[24]  Robert L Kane,et al.  Predicting nursing home admission in the U.S: a meta-analysis , 2007, BMC geriatrics.

[25]  D. Mehr,et al.  MDS Cognitive Performance Scale. , 1994, Journal of gerontology.

[26]  Chantal D. Caron,et al.  Correlates of the Perceived Need for Institutionalisation among Older Adults without Cognitive Impairment , 2008, Gerontology.

[27]  Andy P. Field,et al.  Discovering Statistics Using SPSS , 2000 .

[28]  Ka Lin.  Sectors, Agents and Rationale , 2004 .

[29]  C. Bulpitt,et al.  Population-based multidimensional assessment of older people in UK general practice: a cluster-randomised factorial trial , 2004, The Lancet.

[30]  H. Allore,et al.  Functional Trajectories in Older Persons Admitted to a Nursing Home with Disability After an Acute Hospitalization , 2009, Journal of the American Geriatrics Society.

[31]  Gerdt Sundström,et al.  The changing balance of government and family in care for the elderly in Sweden and other European countries , 2005 .