AI Article Synopsis
- This study aims to explore the relationship between home-based healthcare services and emergency department visits, finding a lack of scientific evidence on the topic.
- Data from 108 patients in southern Taiwan revealed several risk factors for emergency visits, including the Charlson Comorbidity Index, caregiver gender, duration of homecare services, nursing experience, and past emergency department usage.
- Results suggest that understanding these determinants could help policymakers enhance integrated homecare services and reduce unnecessary emergency visits.
Article Abstract
Background: The public health strategy of increasing access to comprehensive home or community-based healthcare services and emergency home visits is intent on reducing the overcrowding of emergency departments. However, scientific evidence regarding the association between home-based healthcare services and emergency department uses is surprisingly insufficient and controversial so far. The present retrospective study identified the risk factors for emergency department visits among patients receiving publicly-funded homecare services.
Methods: The personal demographic and medical information, caregiver characteristics, and behaviours related to homecare services and emergency department visits from the medical records and structured questionnaires of 108 patients who were recipients of integrated homecare services in a regional hospital in southern Taiwan between January 1, 2020, and December 31, 2020, were collected. After screening the potential predictor variables using the preliminary univariate analyses, the multivariate logistic regression with best subset selection approach was conducted to identify best combination of determinants to predict unplanned emergency department utilizations.
Results: Best subset selection regression analysis showed Charlson Comorbidity Index (odds ratio (OR)=1.33, 95% CI=1.05 to 1.70), male caregiver (OR=0.18, 95% CI=0.05 to 0.66), duration of introducing homecare services (OR=0.97, 95% CI=0.95 to 1.00), working experience of dedicated nurses (OR=0.89, 95% CI=0.79 to 0.99) and number of emergency department utilizations within previous past year before enrollment (OR=1.54, 95% CI=1.14 to 2.10) as significant determinants for unplanned emergency department visits.
Conclusions: The present evidence may help government agencies propose supportive policies to improve access to integrated homecare resources and promote appropriate care recommendations to reduce unplanned or nonurgent emergency department visits among patients receiving homecare services.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10699816 | PMC |
| http://dx.doi.org/10.34172/ijhpm.2023.7377 | DOI Listing |
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