Home Healthcare Patients With Distinct Psychological, Cognitive, and Behavioral Symptom Profiles and At-Risk Subgroup for Hospitalization and Emergency Department Visits Using Latent Class Analysis.
Se Hee Min, Jiyoun Song, Lauren Evans and 4 others
PMID 37345951WHAT IT FOUND
In home healthcare patients 65 and older, those with severe psychological, cognitive, and behavioral symptoms were more likely to have hospitalization or emergency department visits within 60 days (18.4% versus 14.8% in the mild symptom group).
Key findings
01Home healthcare patients were grouped into three symptom profiles: moderate psychological symptoms without behavioral issues, severe psychological symptoms with behavioral issues, and mild psychological symptoms without behavioral issues.
02The severe symptom profile had the highest 60-day hospitalization or emergency department visit prevalence, 18.4%, compared with 14.8% in the mild symptom profile.
03After adjustment for age, function, medications, comorbidities, and other covariates, both the moderate and severe profiles had significantly higher odds of hospitalization or emergency department visits than the mild profile.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All data came from one home healthcare organization in the northeastern U.S., so the profiles and rates may not match other home healthcare systems. Class 2 was smaller than the other classes, which may introduce bias. Patients were assigned to latent classes by probability, so some patients may be placed in the wrong symptom profile. Only a few symptom items were available, so other psychological, cognitive, or behavioral symptoms were not included. Symptoms can change over time, but the analysis used admission data to define the profile. The study is observational and exploratory, so it cannot show that symptoms caused hospitalization or emergency department visits.
Declared interests
The supplied publication types list research support from NIH and the U.S. Public Health Service. The supplied text does not include a conflict-of-interest statement.
The easy way to misread this
Do not conclude that treating these symptoms will reduce hospitalization or emergency department visits. This study observed groups with different symptom profiles and different hospitalization or emergency department visit rates. It did not test a treatment.