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Older adults who receive homecare are at increased risk of readmission and mortality following a short ED admission: a nationally register-based cohort study
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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8672634/ https://www.ncbi.nlm.nih.gov/pubmed/34911477 http://dx.doi.org/10.1186/s12877-021-02644-6 |
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author | Elkjær, Mette Wolff, Donna Lykke Primdahl, Jette Mogensen, Christian Backer Brabrand, Mikkel Gram, Bibi |
author_facet | Elkjær, Mette Wolff, Donna Lykke Primdahl, Jette Mogensen, Christian Backer Brabrand, Mikkel Gram, Bibi |
author_sort | Elkjær, Mette |
collection | PubMed |
description | 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-021-02644-6. |
format | Online Article Text |
id | pubmed-8672634 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-86726342021-12-17 Older adults who receive homecare are at increased risk of readmission and mortality following a short ED admission: a nationally register-based cohort study Elkjær, Mette Wolff, Donna Lykke Primdahl, Jette Mogensen, Christian Backer Brabrand, Mikkel Gram, Bibi BMC Geriatr Research 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-021-02644-6. BioMed Central 2021-12-15 /pmc/articles/PMC8672634/ /pubmed/34911477 http://dx.doi.org/10.1186/s12877-021-02644-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Elkjær, Mette Wolff, Donna Lykke Primdahl, Jette Mogensen, Christian Backer Brabrand, Mikkel Gram, Bibi 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 | 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 | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8672634/ https://www.ncbi.nlm.nih.gov/pubmed/34911477 http://dx.doi.org/10.1186/s12877-021-02644-6 |
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