Profiling Patient Characteristics Associated With the Intensity of Nurse Care Coordination.
Tae Youn Kim, Karen D Marek
PMID 27565836WHAT IT FOUND
Older adults receiving nurse home care coordination varied widely in contact time.
Medication complexity, hospitalization, lower cognition and lower mental or physical health were associated with groups needing more nurse hours per quarter.
Key findings
01Nine subgroups were identified among 784 quarterly care episodes; two subgroups comprising 17.1% of episodes required more than 9 hours of nurse time per quarter, and three subgroups comprising 35.3% required less than 6 hours per quarter.
02In each quarter, medication regimen complexity, quality of life, and hospitalization were significantly associated with nurse care intensity; among ten common chronic conditions, only chronic kidney disease and diabetes were associated with increased intensity.
03Participants who were hospitalized required more nurse time, and those with higher medication complexity plus lower mental and physical health status had the highest intensity reported.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a secondary analysis of electronic health record data from one home care medication management program, so it describes documented nurse time rather than tested care effects. Only participants who completed 12 months were analysed, so people who did not complete may be missing. Data quality depended on nurse documentation, and short phone communications may have been underrecorded. The analysis used a liberal p ≤ .10 threshold to select variables, which can increase chance findings. The decision tree groups are profiles of associations, not proof that changing nurse time changes outcomes. The study was in the Midwest, and characteristics such as health literacy were not included.
Declared interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The easy way to misread this
Do not read the subgroup profiles as proof that giving older adults more nurse time improves outcomes. This paper analysed recorded nurse time and factors associated with it; it did not randomly assign different intensities of care.