Using More End-of-Life Homecare Services is Associated With Using Fewer Acute Care Services

摘要: Background: Healthcare systems are investing in end-of-life homecare to reduce acute care use. However, little evidence exists on the timing and amount of services necessary utilization. Objectives: To investigate whether admission time services, as measured by average nursing personal support homemaking (PSH) hours/week (h/wk), associated with using at end-of-life. Research Design: Retrospective observational cohort study. Subjects: Decedents admitted Ontario, Canada. Measures: The odds ratios (OR) having a hospitalization or emergency room visit 2 weeks before death dying hospital. Results: (n = 9018) used an 3.11 (SD 4.87) h/wk, 3.18 6.89) PSH 18% were for < 1 month. As increased, adjusted OR outcome decreased dose response manner. Patients earlier than 6 months had 35% (95% CI: 25%-44%) lower those 3 4 death; patients more 7 h/wk 50% 37%-60%) 21%-47%) hospitalization, respectively, controlling other covariates. Other outcomes similar results. Conclusion: These results suggest that early increased will help alleviate demand hospital resources