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The Impact of Home Care on Recently Discharged Elderly Hospital Patients in an Ontario Community

Published online by Cambridge University Press:  29 November 2010

Larry W. Chambers ,
Peter Tugwell ,
Charles H. Goldsmith ,
Patricia Caulfield ,
Murray Haight ,
Laura Pickard  and
Mary Gibbon
Larry W. Chambers
Affiliation:
Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University
Peter Tugwell
Affiliation:
Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University
Charles H. Goldsmith
Affiliation:
Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University
Patricia Caulfield
Affiliation:
School of Nursing, McMaster University
Murray Haight
Affiliation:
University of Waterloo
Laura Pickard
Affiliation:
Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University
Mary Gibbon
Affiliation:
Retired
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Abstract

Hospital and long-term care facility utilization, mortality and functional status over a 12-month follow-up period are described for elderly home care recipients who had been discharged from an acute care hospital. Of those eligible for receipt of services from the Program, 356 (92%) patients 65 years of age and older agreed to participate in the study at the time of discharge from an acute care hospital. Of these, 82.2 per cent survived during the subsequent 12 months, 44 per cent were readmitted to hospital, and 5 per cent were admitted to a nursing home or home for the aged. After adjusting for socio-demographic and health variables using regression analyses, the total number of home care services received was significantly associated with physical function and social function at 12 months. Similarly, the analyses revealed home care “social services” (social worker visits, meals on wheels, visiting home maker visits and volunteer visits) received were significantly associated with morale at 12 months. The clinical significance of these findings for case-management and home care program management and monitoring are discussed.

Résumé

RÉSUMÉ

Cette étude, qui s'est échelonnée sur une période de 12 mois, examine l'utilisation des services offerts dans les hôpitaux et les foyers d'accueil, la mortalité et l'état fonctionnel de personnes âgées bénéficiant de soins à domicile après avoir quitté une unité de soins actifs. Parmi tous ceux qui avaient droit aux services offerts par le Programme, 356 patients (92%) âgés de 65 ans et plus ont consenti à participer à l'étude au moment où ils quittaient l'unité de soins actifs. 82.2% ont survécu; 44% ont été réadmis à un hôpital tandis que 5% ont été admis à un foyer d'accueil ou à un centre pour gens âgés. Une analyse de régression, incluant des variables socio-démographiques et d'état de santé a révélé que le nombre total des services reçus à domicile était étroitement lié au fonctionnement physique et au fonctionnement social au 12ième mois. Toujours selon les résultats des analyses, les “services sociaux” reçus à domicile (visite du travailleur social, repas livré à domicile, visite d'une ménagère, ou visite d'une bénévole) étaient lies d'une façon significative au moral de la personne à 12 mois. Ces résultats sont discutés, particulièrement en ce qui a trait à la gestion des cas cliniques et en ce qui concerne l'administration de programmes de soins à domicile.

Keywords

Home CareHealth StatusCommunity ProgramsEvaluationCase Management.
Type
Research Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 9 , Issue 4 , Winter/hiver 1990 , pp. 327 - 347
Copyright
Copyright © Canadian Association on Gerontology 1990

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Footnotes

*

This project was conducted with the co-operation of staff of the Home Care Program, which in Hamilton-Wentworth is administered by the Victorian Order of Nurses, Hamilton-Dun-das Branch including Lois Walton, Dr. Dorothy Pringle, Noreen McNairn and Dr. J. Niven Thompson. Staff in the Department of Clinical Epidemiology and Biostatiistics that have assisted with the field work and analysis for this project include: Barbara Sackett and Mary Campbell. Jenny Kosar and Barbara Nethercot typed the drafts of this document. This project was funded through an award from the Ontario Ministry of Health.

1

The Regional Municipality of Hamilton-Wentworth, Department of Public Health Services, P.O. Box 897, Hamilton, Ontario L8N 3P6

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