One-Year Medical Utilization and Mortality in Home Health and Nursing Home Care Recipients from Northern Taiwan

Objectives: Home health care (HHC) and nursing home care (NHC) are mainstays of long-term service in the aged population. Therefore, we aimed to investigate the factors associated with 1-year medical utilization and mortality in HHC and NHC recipients in Northern Taiwan.Design: This study employed a prospective cohort design.Setting and Participants: We enrolled 815 HHC and NHC participants who started receiving medical care services from the National Taiwan University Hospital, Beihu Branch between January 2015 and December 2017.Methods: Multivariate Poisson regression modeling was used to quantify the relationship between care model (HHC vs NHC) and medical utilization. Cox proportional-hazards modeling was used to estimate hazard ratios and factors associated with mortality.Results: Compared with NHC recipients, HHC recipients had higher 1-year utilization of emergency department services [incidence rate ratio (IRR) 2.04, 95% CI 1.16-3.59] and hospital admissions (IRR 1.49, 95% CI 1.14-1.93), as well as longer total hospital length of stay (LOS) (IRR 1.61, 95% CI 1.52-1.71) and LOS per hospital admission (IRR 1.31, 95% CI 1.22-1.41). Living at home or in a nursing home did not affect the 1-year mortality.Conclusions and Implications: Compared with NHC recipients, HHC recipients had a higher number of emergency department services and hospital admissions, as well as longer hospital LOS. Policies should be developed to reduce emergency department and hospitalization utilization in HHC recipients.& COPY; 2023 AMDA -The Society for Post-Acute and Long-Term Care Medicine.

Automated summary

This study investigated the factors associated with 1-year medical utilization and mortality in home health care (HHC) and nursing home care (NHC) recipients in Northern Taiwan. The results showed that compared to NHC recipients, HHC recipients had higher utilization of emergency department services and hospital admissions, as well as longer hospital length of stay. Policies should be developed to reduce emergency department and hospital utilization in HHC recipients.