A before-after study of hospital use in two frail populations receiving different home-based services over the same time in Vancouver, Canada
| العنوان: | A before-after study of hospital use in two frail populations receiving different home-based services over the same time in Vancouver, Canada |
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| المؤلفون: | Michelle B. Cox, Jay Slater, Jeff Poss, Margaret J. McGregor, Lisa A. Ronald, John P. Sloan, Kimberlyn McGrail, Michael Schulzer |
| المصدر: | BMC Health Services Research BMC Health Services Research, Vol 18, Iss 1, Pp 1-11 (2018) |
| بيانات النشر: | BioMed Central, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Frail Elderly, Health informatics, Homecare, Health administration, 03 medical and health sciences, 0302 clinical medicine, Outcome Assessment, Health Care, medicine, Humans, 030212 general & internal medicine, Aged, Retrospective Studies, Aged, 80 and over, Personal care, Geriatric medicine/care of the elderly, British Columbia, Primary Health Care, business.industry, lcsh:Public aspects of medicine, 030503 health policy & services, Health Policy, Nursing research, Public health, lcsh:RA1-1270, Retrospective cohort study, Emergency department, Home Care Services, Community medicine, Hospitals, Patient Discharge, Hospitalization, House Calls, Controlled Before-After Studies, Emergency medicine, Cohort, Female, Family practice/general practice/primary care, 0305 other medical science, business, Emergency Service, Hospital, Facilities and Services Utilization, Research Article |
| الوصف: | Background: As individuals age, they are more likely to experience increasing frailty and more frequent use of hospital services. First, we explored whether initiating home-based primary care in a frail homebound cohort, influenced hospital use. Second, we explored whether initiating regular home care support for personal care with usual primary care, in a second somewhat less frail cohort, influenced hospital use. Methods: This was a before-after retrospective cohort study of two frail populations in Vancouver, Canada using administrative data to assess the influence of two different services started in two different cohorts over the same time period. The participants were 246 recipients of integrated home-based primary care and 492 recipients of home care followed between July 1st, 2008 and June 30th, 2013 before and after starting their respective services. Individuals in each group were linked to their hospital emergency department visit and discharge abstract records. The main outcome measures were mean emergency department visit and hospital admission rates per 1000 patient days for 21 months before versus the period after receipt of services, and the adjusted incidence rate ratios (IRRs) on these outcomes post receipt of service. Results: Before versus after starting integrated home-based primary care, emergency department visit rates per 1000 patient days (95% confidence intervals) were 4.1 (3.8, 4.4) versus 3.7 (3.3, 4.1), and hospital admissions rates were 2.3 (2.1, 2.5) versus 2.2 (1.9, 2.5). Before versus after starting home care, emergency department visit rates per 1000 patient days (95% confidence intervals) were 3.0 (2.8, 3.2) versus 4.0 (3.7, 4.3) visits and hospital admissions rates were 1.3 (1.2, 1.4) versus 1.9 (1.7, 2.1). Home-based primary care IRRs were 0.91 (0.72, 1.15) and 0.99 (0.76, 1.27) and home care IRRs were 1.34 (1.15, 1.56) and 1.46 (1.22, 1.74) for emergency department visits and hospital admissions respectively. Conclusions: After enrollment in integrated home-based primary care, emergency department visit and hospital admission rates stabilized. After starting home care with usual primary care, emergency department visit and hospital admission rates continued to rise. |
| اللغة: | English |
| تدمد: | 1472-6963 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f5d7800b27346d3577c4534e35f1b9b8 http://europepmc.org/articles/PMC5887263 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....f5d7800b27346d3577c4534e35f1b9b8 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14726963 |
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