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 1ADEDOI: 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 cases | All patients 285 | Home group 191 | Other group† 94 | P |
---|---|---|---|---|---|
Age (years) | 272 | 86 (81–91) | 85 (81–90) | 88 (84–93) | * |
Gender, man | 272 | 114 (42%) | 84 (47%) | 30 (33%) | 0.038* |
Number of family members (number) | 182 | 1 (1–2) | 2 (1–2) | 1 (0–2) | 0.005* |
Family member, living with other family members | 182 | 161 (89%) | 127 (93%) | 34 (74%) | 0.001* |
Family member, living with spouse | 182 | 74 (41%) | 63 (46%) | 11 (24%) | 0.009* |
Family member, living with child | 182 | 123 (68%) | 93 (68%) | 30 (65%) | 0.718 |
Family member, living with child’s spouse | 182 | 33 (18%) | 30 (22%) | 3 (6.5%) | 0.025* |
Barthel index on admission | 268 | 65 (30–100) | 85 (55–100) | 30 (5–51) | * |
Bedrriddenness rank on admission, Normal | 271 | 65 (24%) | 61 (34%) | 4 (4.4%) | * |
J1 | 12 (4.4%) | 8 (4.4%) | 4 (4.4%) | ||
J2 | 19 (7.0%) | 19 (11%) | 0 (0.0%) | ||
A1 | 17 (6.3%) | 11 (6.1%) | 6 (6.6%) | ||
A2 | 34 (13%) | 27 (15%) | 7 (7.7%) | ||
B1 | 38 (14%) | 20 (11%) | 18 (20%) | ||
B2 | 33 (12%) | 19 (11%) | 14 (15%) | ||
C1 | 21 (7.7%) | 9 (5.0%) | 12 (13%) | ||
C2 | 32 (12%) | 6 (3.3%) | 26 (29%) | ||
Cognitive function scores on admission, Normal | 270 | 98 (36%) | 85 (47%) | 13 (14%) | * |
1 | 44 (16%) | 33 (18%) | 11 (12%) | ||
2a | 20 (7.4%) | 9 (5.0%) | 11 (12%) | ||
2b | 27 (10%) | 16 (8.9%) | 11 (12%) | ||
3a | 67 (25%) | 33 (18%) | 34 (38%) | ||
3b | 9 (3.3%) | 3 (1.7%) | 6 (6.7%) | ||
4 | 5 (1.9%) | 1 (0.6%) | 4 (4.4%) | ||
M | 0 (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 daily | 266 | 0 (0–1) | 0 (0–0) | 0 (0–4) | * |
Place where the patient was admitted from, home | 212 | 177 (84%) | 147 (97%) | 30 (50%) | * |
Place where the patient was admitted from, LTC facility | 28 (13%) | 3 (2.0%) | 25 (42%) | ||
Place where the patient was admitted from, another hospital | 7 (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 talked | 162 | 38 (24%) | 28 (22%) | 10 (31%) | 0.252 |
Requiring continuous medical treatment after discharge, absent‡ | 125 | 74 (59%) | 55 (71%) | 19 (40%) | 0.001* |
Requiring continuous sputum aspiration after discharge, absent | 125 | 113 (90%) | 74 (96%) | 39 (81%) | 0.010* |
Necessity of home remodeling to stay home after discharge, necessary | 71 | 13 (18%) | 8 (17%) | 5 (21%) | 0.751 |
Facility to which the certified care manager belonged, hospital where the present study was conducted | 101 | 55 (55%) | 36 (61%) | 19 (45%) | 0.156 |
Main diagnosis on dischargea | 285 | –a | –a | –a | 0.462 |
Life expectancy, longer than 6 months | 285 | 264 (93%) | 184 (96%) | 80 (85%) | 0.001* |
Length of hospital stay (day) | 272 | 13 (8–21) | 10 (7–17) | 20 (11–31) | * |
Preference for staying home after discharge (VAS)§ | 178 | 100 (100–100) | 100 (100–100) | 100 (25–100) | * |
Preference for staying at LTC facility after discharge (VAS)§ | 176 | 0 (0–0) | 0 (0–0) | 0 (0–50) | * |
Preference for staying at another hospital after discharge (VAS)§ | 175 | 0 (0–0) | 0 (0–0) | 0 (0–40) | 0.001* |
Preference for staying home during LTC life (VAS)§ | 160 | 100 (50–100) | 100 (50–100) | 70 (0–100) | 0.087 |
Preference for staying at LTC facility during LTC life (VAS)§ | 156 | 0 (0–50) | 0 (0–50) | 50 (0–100) | 0.012* |
Preference for staying at another hospital during LTC life (VAS)§ | 154 | 0 (0–0) | 0 (0–0) | 0 (0–5) | 0.955 |
Preference for staying home at the end stage of life (VAS)§ | 163 | 100 (50–100) | 100 (50–100) | 95 (0–100) | 0.039* |
Preference for staying at LTC facility at the end stage of life (VAS)§ | 159 | 0 (0–50) | 0 (0–20) | 0 (0–50) | 0.018* |
Preference for staying at another hospital at the end stage of life (VAS)§ | 158 | 0 (0–50) | 0 (0–50) | 5 (0–50) | 0.194 |
Whether the patient owned the place of residence, owned | 170 | 163 (96%) | 129 (97%) | 34 (92%) | 0.003* |
Rented | 4 (2.4%) | 4 (3.0%) | 0 (0.0%) | ||
No response | 3 (1.8%) | 0 (0.0%) | 3 (8.1%) | ||
How long the patient lived at the residence (years) | 139 | 59 (42–72) | 58 (39–71) | 68 (47–81) | 0.119 |
Patient’s knowledge of home-visit medical care, 4 levels¶ | 170 | 2 (1–2) | 2 (1–2) | 2 (1–2) | 0.633 |
Patient’s knowledge of on home-visit nursing care, 4 levels¶ | 170 | 2 (1–2) | 2 (1–2) | 2 (1–3) | 0.556 |
Patient’s knowledge of home-visit rehabilitation, 4 levels¶ | 171 | 2 (1–2) | 1 (1–2) | 2 (1–2) | 0.640 |
Patient’s knowledge of home-visit LTC, 4 levels¶ | 171 | 2 (1–3) | 2 (1–3) | 2 (1–3) | 0.466 |
Patient’s knowledge of care manager, 4 levels¶ | 171 | 1 (1–2) | 1 (1–2) | 1 (1–2) | 0.930 |
Patient’s knowledge of care manager in the hospital, 4 levels¶ | 171 | 1 (1–1) | 1 (1–1) | 1 (1–1) | 0.919 |
Patient’s knowledge of LTC insurance system, 4 levels¶ | 170 | 2 (2–3) | 2 (1–3) | 3 (2–4) | 0.002* |
Patient’s knowledge of the cost of home-visit medical care, 3 levels# | 169 | 1 (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# | 169 | 1 (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# | 169 | 1 (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# | 169 | 1 (1–1) | 1 (1–1) | 1 (1–1) | 0.488 |
Patient’s knowledge of the cost of home-visit LTC, 3 levels# | 168 | 1 (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. |