The Association Between Home-Visit Nursing Use and the Incidence of Potentially Avoidable Hospitalisation and Its Duration Among Community-Dwelling Older People: A 12-Month Prospective Cohort Study.
Asa Inagaki-Asano, Chie Fukui, Ayumi Igarashi and 5 others
PMID 41796979WHAT IT FOUND
After accounting for differences, home-visit nursing use was associated with lower chance of hospital stays that might have been avoided with home care.
It was not associated with fewer hospital days.
Key findings
01In bivariate analysis, home-visit nursing use was not significantly associated with potentially avoidable hospitalisation incidence (p = 0.106) or PAH day rate (p = 0.278).
02In the adjusted Poisson model, home-visit nursing users had a statistically significant lower incidence of potentially avoidable hospitalisation (IRR 0.63, 95% CI 0.41 to 0.95).
03In the adjusted linear model among participants with potentially avoidable hospitalisation, there was no significant difference in PAH day rate between home-visit nursing users and non-users (coefficient -0.65, 95% CI -8.35 to 4.50).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 781 of 1450 recruited participants had valid 12-month data, so the analysed group may differ from those who dropped out. Participants who dropped out were more likely to use home-visit nursing, use home-visit physician services, have cancer, or be at end-of-life. The study did not use random sampling, so it may not represent all older people receiving homecare in Japan. Hospitalisation and potentially avoidable hospitalisation were self-reported by clinicians and were not verified. The duration analysis included only 110 participants with potentially avoidable hospitalisation, which limited statistical power. The study could not account for how long home-visit nursing had been used before the study. Because this was an observational cohort, it cannot show that home-visit nursing caused the lower incidence.
The easy way to misread this
Do not conclude that home-visit nursing prevents potentially avoidable hospitalisation. This was an observational study, the unadjusted association was not significant, and the adjusted association does not prove cause. It also did not show shorter hospital days.