Séjours longs en hospitalisation à domicile : impacts des facteurs sociodémographiques, cliniques et des parcours de soins

Abstract

IntroductionAlthough considerable literature exists concerning duration of stay in hospital settings, particularly for long-duration patients, we have little or no information about those hospitalized at home (HAH). We have studied the socio-demographic, clinical characteristics and care pathways of patients having undergone long-duration HAH. MethodsOne hundred and twenty-eight non-obstetric patients having undergone at least seven months of home hospitalization in 2018 and 2019 under the aegis of Assistance publique-Hôpitaux de Paris (AP-HP) were included and compared with 12381 shorter-duration patients. Data came from the French medicalized information system program (PMSI). A multivariate logistic regression model was developed and a descriptive analysis was carried out. ResultsAdvanced age, residing in a nursing home, living alone, having several caregivers and being socially disadvantaged were associated with long-duration home hospitalization (HAH). These patients more often required complex dressings and palliative care, had more severe functional disability and were more frequently readmitted to hospital or died during the same period. In the multivariate model, advanced age, functional disability and transfer to HAH from conventional hospitalization were associated with increasingly lengthier home hospitalization. ConclusionLong-duration home hospitalization was associated with a number of socio-demographic, clinical and care pathway-related factors. Further study of the advantages and drawbacks of HAH is called for.