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Risk factors for the discontinuation of home medical care among low-functioning older patients

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The journal of nutrition, health & aging

Abstract

Objectives

Older patients receiving home medical care often have declining functional status and multiple disease conditions. It is important to identify the risk factors for care transition events in this population in order to avoid preventable transitions. In the present study, therefore, we investigated the factors associated with discontinuation of home medical care as a potentially preventable care transition event in older patients.

Methods

Baseline data for participants in the Observational study of Nagoya Elderly with HOme MEdical (ONEHOME) study and data on the mortality, institutionalization, or hospitalisation of the study participants during a 2-year follow-up period were used. Discontinuation of home care was defined as admission to a hospital for any reason, institutionalization, or death. Univariate and multivariate Cox hazard models were used to assess the association of each of the factors with the discontinuation of home care during the observational period. The covariates included in the multivariate analysis were those significantly associated with the discontinuation of home care at the level of P<0.05 in the univariate analysis.

Results

The univariate Cox hazard model revealed that a low hemoglobin level (< 11g/dL), low serum albumin level (< 3g/dL), higher Charlson Comorbidity Index score, and low Mini Nutritional Assessment Short Form score (< 7) were significantly associated with the discontinuation of home care. A multivariate Cox hazard model including these four factors demonstrated that all four were independently associated with home-care discontinuation.

Conclusions

The present results demonstrated that anemia, hypoalbuminemia, malnourishment, and the presence of serious comorbidities were associated with the discontinuation of home medical care among low-functioning older patients.

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Author information

Authors and Affiliations

  1. Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan

    Hiroyuki Umegaki & M. Kuzuya

  2. Sanei Clinic, 3-560 Komaki, Komaki, Aichi, Japan

    A. Asai

  3. Minami Health-Medical Cooperative Kaname Hospital, Minami, Nagoya, Aichi, Japan

    S. Kanda

  4. Mokuren Clinic, Department of Home Medical Care, Higashi-ku, Nagoya, Aichi, Japan

    K. Maeda

  5. Kachigawa Family Clinic, Kasugai, Japan

    T. Shimojima

  6. Aichi Clinic, Tenpaku, Nagoya, Aichi, Japan

    H. Nomura

Authors
  1. Hiroyuki Umegaki
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  2. A. Asai
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  3. S. Kanda
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  4. K. Maeda
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  5. T. Shimojima
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  6. H. Nomura
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  7. M. Kuzuya
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Correspondence to Hiroyuki Umegaki.

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Umegaki, H., Asai, A., Kanda, S. et al. Risk factors for the discontinuation of home medical care among low-functioning older patients. J Nutr Health Aging 20, 453–457 (2016). https://doi.org/10.1007/s12603-015-0606-9

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  • DOI: https://doi.org/10.1007/s12603-015-0606-9

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