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24 January 2023: Clinical Research

Effects of Caregiver’s Gender or Distance Between Caregiver and Patient’s Home on Home Discharge from Hospital in 285 Patients Aged ≥75 Years in Japan

Yoshimasa Oda 12ABCDEF* , Naoko E. Katsuki 1ABCDEF* , Masaki Tago 1ABDEFG* , Risa Hirata 1CDEF , Osamu Kojiro 3ABE , Masanori Nishiyama 2ADE , Masamichi Oda 3E , Shu-ichi Yamashita 1ADE

DOI: 10.12659/MSM.939202

Med Sci Monit 2023; 29:e939202

Table 1 Comparison between the Home group and the Other group concerning the factors on the side of the patient.

Variable, category (unit)Available casesAll patients 285Home group 191Other group† 94P
Age (years)27286 (81–91)85 (81–90)88 (84–93)*
Gender, man272114 (42%)84 (47%)30 (33%)0.038*
Number of family members (number)1821 (1–2)2 (1–2)1 (0–2)0.005*
Family member, living with other family members182161 (89%)127 (93%)34 (74%)0.001*
Family member, living with spouse18274 (41%)63 (46%)11 (24%)0.009*
Family member, living with child182123 (68%)93 (68%)30 (65%)0.718
Family member, living with child’s spouse18233 (18%)30 (22%)3 (6.5%)0.025*
Barthel index on admission26865 (30–100)85 (55–100)30 (5–51)*
Bedrriddenness rank on admission, Normal27165 (24%)61 (34%)4 (4.4%)*
 J112 (4.4%)8 (4.4%)4 (4.4%)
 J219 (7.0%)19 (11%)0 (0.0%)
 A117 (6.3%)11 (6.1%)6 (6.6%)
 A234 (13%)27 (15%)7 (7.7%)
 B138 (14%)20 (11%)18 (20%)
 B233 (12%)19 (11%)14 (15%)
 C121 (7.7%)9 (5.0%)12 (13%)
 C232 (12%)6 (3.3%)26 (29%)
Cognitive function scores on admission, Normal27098 (36%)85 (47%)13 (14%)*
 144 (16%)33 (18%)11 (12%)
 2a20 (7.4%)9 (5.0%)11 (12%)
 2b27 (10%)16 (8.9%)11 (12%)
 3a67 (25%)33 (18%)34 (38%)
 3b9 (3.3%)3 (1.7%)6 (6.7%)
 45 (1.9%)1 (0.6%)4 (4.4%)
 M0 (0.0%)0 (0.0%)0 (0.0%)
How often the patient’s BPSD appeared, 0: none, 1: once a month, 2: once a week, 3: two or three days/week, 4: almost daily2660 (0–1)0 (0–0)0 (0–4)*
Place where the patient was admitted from, home212177 (84%)147 (97%)30 (50%)*
Place where the patient was admitted from, LTC facility28 (13%)3 (2.0%)25 (42%)
Place where the patient was admitted from, another hospital7 (3.3%)2 (1.3%)5 (8.3%)
Whether the patient had talked with other family members about where and how to live at the end of their lives, had talked16238 (24%)28 (22%)10 (31%)0.252
Requiring continuous medical treatment after discharge, absent 12574 (59%)55 (71%)19 (40%)0.001*
Requiring continuous sputum aspiration after discharge, absent125113 (90%)74 (96%)39 (81%)0.010*
Necessity of home remodeling to stay home after discharge, necessary7113 (18%)8 (17%)5 (21%)0.751
Facility to which the certified care manager belonged, hospital where the present study was conducted10155 (55%)36 (61%)19 (45%)0.156
Main diagnosis on dischargea 285a a a 0.462
Life expectancy, longer than 6 months285264 (93%)184 (96%)80 (85%)0.001*
Length of hospital stay (day)27213 (8–21)10 (7–17)20 (11–31)*
Preference for staying home after discharge (VAS)§ 178100 (100–100)100 (100–100)100 (25–100)*
Preference for staying at LTC facility after discharge (VAS)§ 1760 (0–0)0 (0–0)0 (0–50)*
Preference for staying at another hospital after discharge (VAS)§ 1750 (0–0)0 (0–0)0 (0–40)0.001*
Preference for staying home during LTC life (VAS)§ 160100 (50–100)100 (50–100)70 (0–100)0.087
Preference for staying at LTC facility during LTC life (VAS)§ 1560 (0–50)0 (0–50)50 (0–100)0.012*
Preference for staying at another hospital during LTC life (VAS)§ 1540 (0–0)0 (0–0)0 (0–5)0.955
Preference for staying home at the end stage of life (VAS)§ 163100 (50–100)100 (50–100)95 (0–100)0.039*
Preference for staying at LTC facility at the end stage of life (VAS)§ 1590 (0–50)0 (0–20)0 (0–50)0.018*
Preference for staying at another hospital at the end stage of life (VAS)§ 1580 (0–50)0 (0–50)5 (0–50)0.194
Whether the patient owned the place of residence, owned170163 (96%)129 (97%)34 (92%)0.003*
 Rented4 (2.4%)4 (3.0%)0 (0.0%)
 No response3 (1.8%)0 (0.0%)3 (8.1%)
How long the patient lived at the residence (years)13959 (42–72)58 (39–71)68 (47–81)0.119
Patient’s knowledge of home-visit medical care, 4 levels 1702 (1–2)2 (1–2)2 (1–2)0.633
Patient’s knowledge of on home-visit nursing care, 4 levels 1702 (1–2)2 (1–2)2 (1–3)0.556
Patient’s knowledge of home-visit rehabilitation, 4 levels 1712 (1–2)1 (1–2)2 (1–2)0.640
Patient’s knowledge of home-visit LTC, 4 levels 1712 (1–3)2 (1–3)2 (1–3)0.466
Patient’s knowledge of care manager, 4 levels 1711 (1–2)1 (1–2)1 (1–2)0.930
Patient’s knowledge of care manager in the hospital, 4 levels 1711 (1–1)1 (1–1)1 (1–1)0.919
Patient’s knowledge of LTC insurance system, 4 levels 1702 (2–3)2 (1–3)3 (2–4)0.002*
Patient’s knowledge of the cost of home-visit medical care, 3 levels# 1691 (1–1)1 (1–1)1 (1–1)0.050*
Patient’s knowledge of the cost of home-visit nursing care under medical insurance system, 3 levels# 1691 (1–1)1 (1–1)1 (1–1)0.050*
Patient’s knowledge of the cost of home-visit nursing care under LTC insurance system, 3 levels# 1691 (1–1)1 (1–1)1 (1–1)0.387
Patient’s knowledge of the cost of home-visit rehabilitation under LTC insurance, 3 levels# 1691 (1–1)1 (1–1)1 (1–1)0.488
Patient’s knowledge of the cost of home-visit LTC, 3 levels# 1681 (1–1)1 (1–1)1 (1–1)0.048*
Categorical variables are presented as absolute numbers (percentage) and are compared using the chi-square test. Continuous variables are presented as medians (interquartile range) and are compared using Mann-Whitney U test.
The other group includes the patient who stayed or deceased at either LTC facilities or another hospital after discharge.
Necessary medical treatment was defined as follows: presence of presence of pressure ulcer, skin wound, or gastric, colonic, or urinary stoma; necessity for applying ointment, self-injection, sputum aspiration, or respirator, urethral catheter, intravenous infusion, or administration of oxygen; or self-monitoring of blood glucose.
§ Preference was asked by VAS ranging from 0 to 100.
The knowledge of each service was asked by 4 levels, 1: had never heard about the service, 2: had heard the term, 3: was well informed, 4: had experience of use.
# The knowledge of the cost of each service was asked by 3 levels; 1: had never heard the cost, 2: had heard the cost, 3: had experience of using the service.
a The Distribution of the top 10 main diagnosis is presented in .
*
LTC – long-term care; BPSD – behavioral and psychiatric symptoms of dementia; VAS – visual analog scales.

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750