Abstract
BackgroundEmergency department visits and hospitalizations (EDVH) place a large burden on patients and the health care system. The presence of informal caregivers may be beneficial for reducing EDVH among patients with specific diagnoses. Our objective was to determine whether the presence of an informal caregiver was associated with the occurrence of an EDVH among clients 50 years of age or older.MethodsUsing a database accessed through the Toronto Central Community Care Access Centre (CCAC), we identified 479 adults over 50 years of age who received home care in Toronto, Canada. Exposure variables were extracted from the interRAI health assessment form completed at the time of admission to the CCAC. EDVH data were linked to provincial records through the CCAC database. Data on emergency room visits were included for up to 6 months after time of admission to home care. Multiple logistic regression analysis was used to identify factors associated with the occurrence of an EDVH.ResultsApproximately half of all clients had an EDVH within 180 days of admission to CCAC home care. No significant association was found between the presence of an informal caregiver and the occurrence of an EDVH. Significant factors associated with an EDVH included: Participants having a poor perception of their health (adjusted OR = 1.68, 95% CI: 1.11–2.56), severe cardiac disorders (adjusted OR = 1.54, 95% CI: 1.04–2.29), and pulmonary diseases (adjusted OR = 1.99, 95% CI: 1.16–3.47).ConclusionsThe presence of an informal caregiver was not significantly associated with the occurrence of an EDVH. Future research should examine the potential associations between length of hospital stay or quality of life and the presence of an informal caregiver. In general, our work contributes to a growing body of literature that is increasingly concerned with the health of our aging population, and more specifically, health service use by elderly patients, which may have implications for health care providers.
Highlights
IntroductionVan Houtven and Norton [8] reported that informal care provided by adult children did not significantly affect the likelihood of hospitalization for single individuals aged 70 and older
Emergency department visits and hospitalizations (EDVH) place a large burden on patients and the health care system
Sample characteristics Of the 479 participants included in the analysis, 215 (44.9%) indicated the presence of an informal caregiver (Table 1)
Summary
Van Houtven and Norton [8] reported that informal care provided by adult children did not significantly affect the likelihood of hospitalization for single individuals aged 70 and older. A subsequent study by the same authors [9], which examined Medicare expenditures among single elderly patients, found that informal care by adult children did not affect the occurrence of a Medicare-financed hospitalization, but did reduce Medicare expenditures. Using the 2004 Survey of Health, Ageing and Retirement in Europe, Bolin et al [11] found that informal care provided by children and grandchildren (the mean age of the eldest child was 37 years) increased the likelihood of hospitalizations in single individuals aged 50 and older. In a cohort of 55 to 85 year old adults from the Longitudinal Ageing Study Amsterdam, Pot et al [12] found that living with a partner increased the likelihood of an individual to see a medical specialist, but showed no significant association with the occurrence of a hospitalization
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