Predictors and trajectories of ED visits among patients receiving palliative home care services: findings from a time series analysis (2013-2017)

摘要: Current policies recommend integrating home care and palliative to enable patients remain at avoid unnecessary hospital admission emergency department (ED) visits. The Italian health system had implemented integrated (IHPC) services guarantee a comprehensive, coordinated approach across different actors reduce potentially avoidable ED This study aimed analyze the trajectories of visit rates among receiving IHPC in healthcare system, as well association between socio-demographic, supply, clinical factors. A pooled, cross-sectional, time series analysis was performed large region period 2013–2017. Data were taken from two databases official National Information System: Home Care Services use. record is opened patient enrolled closed after last service provided. Every such considered an event, only visits that occurred during events considered. 20,611 contributed 23,085 events; ≥1 6046 these events. Neoplasms accounted for 89% 91% Although there variations period, slight decline observed all diseases, this accelerated over (b = − 0.18, p = 0.796, 95% confidence interval [CI] = − 1.59;1.22, b-squared = − 1.25, p < 0.001, CI = -1.63;-0.86). There no significant predictors socio-demographic factors (sex, age, presence non-family caregiver, cohabitant family members, distance ED), supply (proponent IHPC) (prevalent disorder entry, symptoms). Our results show use continues enrollment IHPC, but trend declines time. As predictive identified, specific interventions can be recommended on which depend.