Factors associated with unexpected admissions and mortality among low-functioning older patients receiving home medical care.

Aim: The need for and availability of home medical care for elderly patients with limitations in terms of access to medical facilities has been increasing. We investigated the association between low function, malnutrition, dementia and multicomorbidity with patient prognosis, focusing on unexpected hospital admissions and mortality in elderly non-cancer patients receiving home care.

Methods: The study included 124 Japanese patients receiving home medical care in the form of regular visits from doctors and nurses for physical and/or mental disability.

Results: Of the patients studied, 36.2% experienced hospital admission. Student's t-test showed that admitted patients had significantly higher Charlson Comorbidity Index scores. Meanwhile, 19.6% of patients died during the course of the study. Student's t-test showed that older patients had a higher risk of mortality, and significantly lower activities of daily living and Mini-Nutritional Assessment Short-Form scores. Cox hazard analysis showed that multicomorbidity was a risk for unexpected hospital admission, and malnutrition was a risk for mortality in frail older adults receiving home medical care.

Conclusions: We found that multicomorbidity was a risk for unexpected hospital admission, and malnutrition was a risk for mortality in frail older adults receiving home medical care. Geriatr Gerontol Int 2017; 17: 1623-1627.