Title

From Hospital to Home and Back Again: A Study in Hospital Admissions and Deaths for Home Care Patients

Publication Title

Home Health Care Management and Practice

Publication Date

10-2005

Document Type

Article

DOI

10.1177/1084822305278129

Keywords

home care, quality, death, hospital admissions, health care, falls at home, polypharmacy

Disciplines

Nursing

Abstract

In this study, the authors examined causes of deaths or hospitalizations of adult home care patients during an 18-month period using a retrospective medical record audit. The site of the study was the home care program of a three-hospital system. Of 4,303 cases, 101 adult patients met study criteria of hospitalization or death. The death rate in the sample was 0.48%, and the hospitalization rate was 1.9%. Wound deterioration and falling accidents were principal causes for rehospitalizing patients. Increasing age and number of medications were significantly correlated with falls resulting in hospitalization. Patients who died were found to suffer from terminal illnesses and frailty, with care providers having little influence over outcomes. Opportunities to improve clinical care processes (e.g., discharge planning, patient status monitoring, signs and symptoms reporting, interdisciplinary communicating and coordinating) were also identified. The authors concluded that nearly 21% of hospitalizations were potentially preventable.

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