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Association between home-visit nursing utilization and all-cause hospitalization among long-term care insurance beneficiaries: A retrospective cohort study.
International Journal of Nursing Studies 2017 October
BACKGROUND: Ensuring and improving long-term care services that use limited healthcare resources more efficiently is a major concern for many aging societies.
OBJECTIVES: The aim of this study was to investigate the relationship between use of home-visit nursing services and all-cause hospitalization in a home-visit nursing-recommended group.
DESIGN: A retrospective cohort study.
SETTING: Population-based sample of long-term care insurance beneficiaries from the long-term care insurance 2002-2013 claims database in South Korea.
PARTICIPANTS: Long-term care insurance beneficiaries who need one or more types of nursing care were defined as the home-visit nursing -recommended group (n=4173).
MEASUREMENTS: The dependent variable in this study was all-cause hospitalization in the home-visit nursing-recommended population. Multivariate Cox proportional hazards regression analysis was used to identify the association between home-visit nursing service use and all-cause hospitalization.
RESULTS: A total of 3.8% of the subjects used home-visit nursing services. When participants who used home-visit nursing services were set as the reference group, participants who did not use home-visit nursing services had a higher risk of hospitalization (hazard ratio [HR]=1.25, 95% confidence interval [CI]=1.07-1.47). Additionally, participants who did not use home-visit nursing services and who did not have a caregiver showed a marked increase in the risk of hospitalization (HR=6.81, 95% CI=1.17-39.66). Participants who did not use home-visit nursing services with greater comorbidity showed a considerable increase in risk of hospitalization (HR=1.36, 95% CI=1.09-1.70).
CONCLUSIONS: Non-use of home-visit nursing services was associated with an increased risk of all-cause hospitalization in the home-visit nursing-recommended population. The present results suggest that the use of home-visit nursing services reduced the risk of hospitalization. Moreover, home-visit nursing may play an essential role in reducing hospitalization risk in the absence of caregiver support.
OBJECTIVES: The aim of this study was to investigate the relationship between use of home-visit nursing services and all-cause hospitalization in a home-visit nursing-recommended group.
DESIGN: A retrospective cohort study.
SETTING: Population-based sample of long-term care insurance beneficiaries from the long-term care insurance 2002-2013 claims database in South Korea.
PARTICIPANTS: Long-term care insurance beneficiaries who need one or more types of nursing care were defined as the home-visit nursing -recommended group (n=4173).
MEASUREMENTS: The dependent variable in this study was all-cause hospitalization in the home-visit nursing-recommended population. Multivariate Cox proportional hazards regression analysis was used to identify the association between home-visit nursing service use and all-cause hospitalization.
RESULTS: A total of 3.8% of the subjects used home-visit nursing services. When participants who used home-visit nursing services were set as the reference group, participants who did not use home-visit nursing services had a higher risk of hospitalization (hazard ratio [HR]=1.25, 95% confidence interval [CI]=1.07-1.47). Additionally, participants who did not use home-visit nursing services and who did not have a caregiver showed a marked increase in the risk of hospitalization (HR=6.81, 95% CI=1.17-39.66). Participants who did not use home-visit nursing services with greater comorbidity showed a considerable increase in risk of hospitalization (HR=1.36, 95% CI=1.09-1.70).
CONCLUSIONS: Non-use of home-visit nursing services was associated with an increased risk of all-cause hospitalization in the home-visit nursing-recommended population. The present results suggest that the use of home-visit nursing services reduced the risk of hospitalization. Moreover, home-visit nursing may play an essential role in reducing hospitalization risk in the absence of caregiver support.
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