Aims: This study aimed to identify factors associated with inpatient facility admissions among adults 50 years and older with diabetes receiving home health care (HHC) at home or in assisted living (AL) and examine whether associated factors are similar or different between the two groups.
Rationale: There is a high risk for inpatient facility admissions among HHC patients with diabetes. HHC is primarily provided to patients in their own homes but is increasingly provided to patients residing in AL. Older adults living in different settings may have unique risk factors.
Conceptual framework and supporting literature: This study was guided by Anderson’s Behavioral Model of Health Services Use, which suggests that healthcare utilization is influenced by predisposing, enabling, and need factors.
Methods: This retrospective study of HHC patients with diabetes 50 years and older (n=5,308) used data from the outcome and assessment information set D (OASIS-D). Using logistic regression, we examined whether characteristics at the start of HHC were associated with having an inpatient admission while receiving HHC. Two separate models were completed for patients living at home and patients in assisted living.
Results: The mean age of the overall sample was 75.6 (SD 9.5) and patients were 57.5% female; 29.5% of patients had an inpatient admission while receiving HHC. Multiple prior hospitalizations, depression, limited cognitive function, decreased ability to perform activities of daily living, and an unhealed pressure ulcer or injury ≥ stage 2 were associated with having an inpatient admission in patients living at home receiving HHC. Multiple prior hospitalizations and decreased ability to perform activities of daily living were associated with having an inpatient admission in patients in AL receiving HHC.
Applicability to advanced practice nursing practice: This study aids in understanding risk factors for inpatient admissions among patients with diabetes living at home or in AL. The results may support identification of at-risk patients and inform targeted interventions to prevent inpatient admissions while receiving HHC.
Learning outcome: At the end of the presentation, attendees will be able to list factors associated with inpatient transfers in home health patients age ≥50 with diabetes.
After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.