Home Health Care Providers Research Articles

Evaluation of Home Healthcare Services By Service Providers and Users

Background: On May 15, 2017, the Turkish Ministry of Health transferred the coordination and delivery of home healthcare services from primary healthcare facilities to hospitals. Objective:This study aims to find out what the patients, their families, and home healthcare providers think about this organizational change that has been made to the service delivery process. Methods: In the quantitative research, the survey created using the results of qualitative research was administered to 396 individuals, comprising 322 patients or their relatives and 74 medical staff members. The survey's reliability was assessed using Cronbach's alpha coefficient, its validity was assessed using exploratory and confirmatory factor analyses, and the t-test was used to test the hypotheses. Results: Following the transfer of home health service delivery and coordination from primary healthcare institutions to hospitals, it was found that visit frequency-satisfaction, equity, monitoring-evaluation, and socio-economic support were the dimensions in which patients and their relatives participated more than healthcare personnel. However, compared to patients or patient relatives, healthcare personnel participate more in the areas of access to services, personnel-financial support, and private sector-security support. Conclusions: According to these findings, it is noteworthy that both groups have a much higher level of participation in issues that directly concern them. Thus, it is believed that improving the problems that clients and staff find objectionable will enhance home health services. Keywords: Home care; healthcare providers; healthcare users; primary healthcare; hospitals

Predictive Factors of Peripheral Arterial Disease in Home Care Patients

Objective: The aim of the present study was to investigate the predictive factors of peripheral arterial disease (PAD) in home care patients. Materials and Methods: This descriptive study was conducted in Istanbul with 285 homebound patients who applied for the first time to receive services from the Home Health Care Unit of a tertiary hospital between 01.07.2014 and 01.12.2014. The patients having known PAD diagnosis were excluded. Sociodemographic characteristics, home dependency duration, chronic diseases, medications used and smoking status were recorded. Then, deformities in the patients' toenails, peripheral hair loss, foot wounds were recorded, and the patients' functional status and skinfold thickness were evaluated peripheral arterial disease was evaluated by ankle–brachial index (ABI). An ABI below 0.9 was considered indicative of PAD. A chi-square test, Mann–Whitney U test and a logistic regression analysis were used in the statistical analysis. Results: The mean age of the participants was 75.84±1.17 years (34% M; 65% F). Peripheral artery disease was detected in 16.8% (n=48) of the patients. Current or former smoking (β: 4.09), peripheral hair loss (β: 3.42), deformity of toenails (β: 3.02), and increased skinfold thickness (β: 1.124) were identified as predictors of PAD. Conclusion: The findings of the present study suggest that home healthcare providers should inquire about the patient's smoking history, assess skinfold thickness, and examine the toes for hair loss and deformities, to predict PAD.

Hospital-to-Home-Health Transition Quality (H3TQ) Index: Further Evidence on its Validity and Recommendations for Implementation.

We developed the Hospital-to-Home-Health Transition Quality (H3TQ) Index for skilled home healthcare (HH) agencies to identify threats to safe, high-quality care transitions in real time. Assess the validity of H3TQ in a large sample across diverse communities. A survey of recently hospitalized older adults referred for skilled HH services and their HH provider at two large HH agencies in Baltimore, MD, and New York, NY. There were five hundred eighty-seven participants (309 older adults, 141 informal caregivers, and 137 HH providers). Older adults, caregivers, and HH providers rated 747 unique transitions. Of these, 403 were rated by both the older adult/caregiver and their HH provider, whereas the remaining transitions were rated by either party. Construct, concurrent, and predictive validity were assessed via the overall H3TQ rating, correlation with the care transition measure (CTM), and the Medicare Outcome and Assessment Information Set (OASIS). Proportion of transitions with quality issues as identified by HH providers and older adults/caregivers, respectively; Baltimore 55%, 35%; NYC 43%, 32%. Older adults/caregivers across sites rated their transitions as higher quality than did providers (P<0.05). H3TQ summed scores showed construct validity with the CTM-3 and concurrent validity with OASIS measures. Summed H3TQ scores were not significantly correlated with 30-day ED visits or rehospitalization. The H3TQ identifies care transition quality issues in real-time and demonstrated construct and concurrent validity, but not predictive validity. Findings demonstrate value in collecting multiple perspectives to evaluate care transition quality. Implementing the H3TQ could help identify transition-quality intervention opportunities for HH patients.

Characterizing changes to older adults' care transition patterns from hospital to home care in the initial year of COVID-19.

Skilled home healthcare (HH) provided in-person care to older adults during the COVID-19 pandemic, yet little is known about the pandemic's impact on HH care transition patterns. We investigated pandemic impact on (1) HH service volume; (2) population characteristics; and (3) care transition patterns for older adults receiving HH services after hospital or skilled nursing facility (SNF) discharge. Retrospective, cohort, comparative study of recently hospitalized older adults (≥ 65 years) receiving HH services after hospital or SNF discharge at two large HH agencies in Baltimore and New York City (NYC) 1-year pre- and 1-year post-pandemic onset. We used the Outcome and Assessment Information Set (OASIS) and service use records to examine HH utilization, patient characteristics, visit timeliness, medication issues, and 30-day emergency department (ED) visit and rehospitalization. Across sites, admissions to HH declined by 23% in the pandemic's first year. Compared to the year prior, older adults receiving HH services during the first year of the pandemic were more likely to be younger, have worse mental, respiratory, and functional status in some areas, and be assessed by HH providers as having higher risk of rehospitalization. Thirty-day rehospitalization rates were lower during the first year of the pandemic. COVID-positive HH patients had lower odds of 30-day ED visit or rehospitalization. At the NYC site, extended duration between discharge and first HH visit was associated with reduced 30-day ED visit or rehospitalization. HH patient characteristics and utilization were distinct in Baltimore versus NYC in the initial year of the COVID-19 pandemic. Study findings suggest some older adults who needed HH may not have received it, since the decrease in HH services occurred as SNF use decreased nationally. Findings demonstrate the importance of understanding HH agency responsiveness during public health emergencies to ensure older adults' access to care.

Covid-19: The impact of lockdown on the dispensing of hospital drugs to outpatients

In response to the COVID-19 pandemic, France was under lockdown for the first time from March 17 to May 10, 2020. The aim of this work is to study the impact of lockdown on outpatients’ visits to the hospital pharmacy to collect chronic medication, in order to highlight the pharmaceutical classes concerned and to assess whether a decrease in medication adherence could be observed. Retrospectively, using hospital dispensing traceability software, the dispensing of drugs during the eight weeks of lockdown was compared with that during the two eight-week periods before and after lockdown. Evolutions in the number of medicine lines dispensed and outpatient visits were analyzed over the three time periods, according to pharmaceutical classes. A specific analysis was performed between drugs only available at the hospital pharmacy and drugs available at both the community and hospital pharmacy. During lockdown, 67% of patients still came regularly, but a significant decrease in the average number of lines dispensed was observed. 15% of regular patients limited their visits during this period. Patients taking drugs available at both the community and hospital pharmacy were significantly more impacted than those taking drugs that could only be dispensed at the hospital pharmacy. On the other hand, age is not a factor associated with the restriction of visits. Lockdown affected the visits to the hospital pharmacy of at least one in ten regular outpatients. Sending hospital drugs to community pharmacies and the help of home health care providers limited therapeutic disruptions.

“Returning to the core tasks”: a qualitative interview study about how general practitioners in home health care solved problems during the COVID-19 pandemic

Objective Optimizing care at home, or home health care (HHC), is necessary as the population of care-dependent older people receiving care at home steadily increases. The COVID-19 pandemic tested Swedish primary care professionals as they provided HHC for a population of very frail older homebound people, but a better understanding of what healthcare workers did to manage the crisis may be useful for the further development of HHC. In this study, we aimed to understand how HHC physicians solved the problems of providing home healthcare during the pandemic to learn lessons on how to improve future HHC. Methods This is a qualitative study of individual interviews with 11 primary care physicians working in HHC (8 women) from 7 primary care practices in Region Stockholm, Sweden. Interviews were conducted between 1 December 2020, and 11 March 2021. The data were analyzed using inductive thematic analysis. Results We generated an overarching theme in our analysis: Physicians focus on core tasks and professional values in response to crisis. This theme incorporated three underlying subthemes describing this response: physicians prioritize and resolve ethically challenging situations in new ways, cultivate the patient perspective, and build on existing teams. Conclusion This study indicates that a healthcare system that gives HHC physicians agency to focus on core tasks and professional values could promote person-centered care.

Providing Home Healthcare Services for Patients during Pandemics: Applicability in Developing Countries

The need for a systematic way to provide routine healthcare services for patients during pandemics is one of the priorities of the healthcare sector, especially when the country is in lockdown. In this article, we study the possibility of providing healthcare services for patients at their homes during pandemics in developing countries where such a system is not available. We present a technology-based solution and examine the possibility of its adaptation through a number of theoretical perspectives that examine changes in healthcare systems in general. Examining the theories of change revealed that providing healthcare services at home is a must during pandemics, and it has a significant role in improving the healthcare sector and in providing valuable services to patients, especially when the county is on lockdown. However, a number of challenges do exist for 0its adaptation in developing countries. These challenges are concerned with the costs of developing and maintaining the new system, as well as ensuring a precise and accurate healthcare service to be delivered on time and without any faults or errors. Having a well-studied plan by the health sector, an efficient scheduling mechanism for the healthcare services’ requests, and a service monitoring system can overcome all challenges and ensure a better quality of life for patients.

Satisfaction with Home Healthcare Provider Service in Adults with Type 1 Diabetes Using a Hybrid Closed Loop System: The SATURN Study

Introduction: Hybrid closed loop (HCL) systems have the potential to improve glycaemic control in people with Type 1 diabetes (T1D). In France, patient technical education and assistance for HCL users is provided by trained nurses from home healthcare providers (HHP). The objective of this study was to evaluate satisfaction of people with T1D with HHP services. Methods: In total, 35 participants with T1D and a prescription for an HCL system were studied during 3 months after HCL initiation in two French hospitals. A series of questionnaires were completed by participants. The number of planned (per protocol) and unplanned HHP interactions was monitored. Glycaemic control at inclusion and Day 90 was compared; formal statistical testing was carried out post-hoc. Results: Client Satisfaction Questionnaire (CSQ-8) with HHP service was high both at Day 30 (mean CSQ-8 score: 28.9; 95% confidence interval [CI]: 28.0; 29.9) and at Day 90 (29.0; 95% CI: 27.9; 30.0). Hypoglycemia Fear Survey-II (HFS-II) score (standard deviation) decreased from 31.2 (±15.7) at inclusion to 23.1 (±16.8) at Day 90. Participants had a median number of four home visits and two phone calls, but important differences were observed between participants: total interactions with HHP nurses ranged between five and 12 contacts, and 45.7% of participants requested unplanned interactions. Glycaemic control improved significantly: mean time in range increased from 57.0% (±13.3) at inclusion to 71.4% (±9.4) at Day 90 (p&lt;0.001). Conclusion: HHP services for early phase HCL implementation were met with high client satisfaction levels. Study results emphasise the need for a personalised HHP approach.

Care Burden and Life Satisfaction of Caregivers Who are Providing Home Health Care to Patients.

This study aims to evaluate the care burden and life satisfaction in caregivers who are providing home health care to patients and determine the relationship between life satisfaction and care burden. This cross-sectional descriptive study was performed on 133 caregivers who provided home health care to patients and 133 control groups between February and December 2020. Care burden was evaluated using the Zarit Burden Inventory (ZBI), and life satisfaction was evaluated using the Satisfaction with Life Scale (SWLS). The mean age of hundred thirty-three caregivers was 52.5±10.5 years, and that of the control group was 51.2±9.9 years. The mean ZBI score of the caregivers was 47.0±16.4. According to the ZBI score, 46.6% of the caregivers had a moderate care burden and 21.8% had a heavy caregiver burden. The caregiver burden was higher in those with a low education level, those without social insurance, those who felt insufficient in care, and those who did not receive help from other family members. The SWLS score of caregivers was significantly lower than that of control group (p<0.001). The SWLS score was lower in those with a low education level and those without an employee as a caregiver. There was a negative correlation between SWLS and ZBI score (p<0.001). Caregivers of patients receiving home health-care services are exposed to a significant care burden. The care burden was higher in those with a low education level, those without social insurance, those who felt insufficient in care, and those who did not receive help from other family members. The care burden affects the satisfaction of life.

Home not alone : transition from hospital to home nutrition care, what to consider?

Malnutrition is said to be the “skeleton in the hospital closet”, mainly because it is overlooked undiagnosed, and untreated. This applies to the “home closet” as well, often being forgotten in the discharge planning and transition from hospital to home.&#x0D; Family physicians are well-qualified to provide home health care since this requires continuing and comprehensive management in a family context. It is the family physician that can initiate the decision to transition to home care, and is directly involved in the planning and coordination of the services.

Factors influencing home health care providers' performance of oral health care for older people: A qualitative study.

To examine factors that affect the performance of oral health care (OHC) for older people receiving nursing care at home. Oral health is often neglected by health care providers caring for older people. Research shows that health care providers' provision of OHC may be influenced by various factors (barriers and facilitators). When this research was conducted, health care providers from home healthcare services (HHCS) and nursing homes were grouped together despite setting differences; therefore, this study focuses on the performance of OHC by home health care providers (HHCPs) as a single group. Explorative design with a qualitative approach. The managers of four HHCS units recruited 17 HHCPs to participate in focus group interviews. One interview was conducted per unit, and there were four to five participants in each interview. The analysis of interviews was based on theoretical thematic analysis and the PRECEDE constructs in the PRECEDE-PROCEED model. Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were used in reporting this study. The analysis resulted in two themes with predisposing factors (HHCPs' professional responsibilities, older people's attitude), five themes with enabling factors (knowledge and skills, older people/carer trust, available time, available equipment and collaboration with public dental service (PDS)), and two themes with reinforcing factors (routines and OHC focus on the workplace) that affect the provision of OHC. The factors were categorised as individual, organisational and collaboration factors. In addition to individual factors found in previous studies, factors related to the organisation of services and communication between HHCPs and PDS seem to affect HHCPs' provision of OHC for adults receiving HHCS. This study provides in-depth knowledge that can contribute to increasing HHCPs' provision of OHC and thereby prevent oral and dental disease among older people receiving HHCS.

Solving Health &amp; Safety Hazards Encountered in Client Homes: Effective Communication With Clients &amp; Families

Abstract Date Presented 04/22/2023 Communicating with clients and families about health and safety hazards in their homes can be challenging. This study developed guidance for home health care providers about communication strategies to address difficult conversations. Primary Author and Speaker: Amy Darragh Additional Authors and Speakers: Sarah Anderson, Barbara Polivka Contributing Authors: Angela Provenzano, Haley Oliver, Steve Lavender, Carolyn Sommerich

Estimation of service length with the machine learning algorithms and neural networks for patients who receiving home health care

The main purpose of the study is to develop an estimation model using machine learning algorithms and to ensure the effective and efficient implementation of home health care service planning in hospitals with these algorithms. The necessary approvals for the study were obtained. The data set was created by obtaining patient data (except for data such as Turkish Republic identification number) from 14 hospitals providing Home Health Care Services in the city of Diyarbakır. The data set was subjected to necessary pre-processing and descriptive statistics were applied. For the estimation model, Decision Tree, Random Forest and Multi-layer Perceptron Neural Network algorithms were used. It was found that the number of days of home health care service, which the patients received, varied depending on their age and gender. It was observed that the patients were generally in the disease groups that required Physiotherapy and Rehabilitation treatments. It was determined that the length of service for patients can be predicted with a high reliability rate (Multi-Layer Model Acc: 90.4%, Decision Tree Model Acc: 86.4%, Random Forest Model Acc: 88.5%) using machine learning algorithms. In the light of the findings and data patterns obtained in the study, it is thought that effective and efficient planning will be made in terms of health management. In addition, it is believed that estimating the average length of service for patients will contribute to strategic planning of human resources for health, and to reducing medical consumables, drugs and hospital expenses.

The multi-period home healthcare routing and scheduling problem with electric vehicles.

This paper studies the multi-period home healthcare routing and scheduling problem with homogeneous electric vehicles and time windows. The problem aims to construct the weekly routes of healthcare nurses, which provide service to the patients located at a scattered geographic area. Some patients may require to be visited more than once in the same workday and/or in the same workweek. We consider three charging technologies; normal, fast, and super-fast. The vehicles might be charged during the working day at a charging station or at the end of the working day at the depot. Charging a vehicle at a depot at the end of a working day requires the transfer of the corresponding nurse from the depot to her/his home. The objective is to minimize the total cost that comprises the fixed cost of utilizing healthcare nurses, the energy charging costs, the costs associated with depot-to-nurse home transfer services, and the costs of a patient left unserved. We formulate a mathematical model and develop an adaptive large neighborhood search metaheuristic that has been efficiently crafted to handle specific problem features. We conduct extensive computational experiments on benchmark instances to assess the competitiveness of the heuristic and to deeply analyze the problem. Our analysis shows the importance of competency level matching as mismatching competency levels could increase the costs of home healthcare providers.

Palliative and end-of-life care in Parkinson’s disease: a survey of patients’ perceptions and knowledge in France (P8-6.003)

<h3>Objective:</h3> To evaluate patients’ perceptions and knowledge regarding palliative and end-of-life care in Parkinson’s disease <h3>Background:</h3> Palliative care is receiving a growing interest in PD. Little is known, however, about PD patients’ perceptions, knowledge or experience. Until now, no study has been carried out in France to assess (i) if PD patients talk about these topics with healthcare professionals or their families, (ii) or if they use the available legal documents (advance directives and trusted person). Understanding the current situation is critical to identify levers for action and improve patients’ access to palliative care resources. <h3>Design/Methods:</h3> Anonymous online questionnaire (available for 10 days), with the survey link sent by email to participants through various PD patients’ associations (France Parkinson, APIV) and home healthcare provider nurses <h3>Results:</h3> 60 patients (51.7% women, 56.7% over 70 years old) voluntarily completed the survey. The majority of patients do not consider themselves well informed about palliative care (68.3%). They never discuss palliative care with their medical team (86.7%) nor their family (68.3%). However, they think they can benefit from palliative care because of their illness (65%) and want more information on this subject (58.3%). Most patients have already thought about the end of life (71.%) and find it scary (68.3%). They never have end-of-life discussions with their medical team (80%) or their family (51.7%). They have never received any documentation from professionals (58.3%). Only 51.7% are aware of the existence of an end-of-life law. Although they consider it important, few patients have already designated their trusted person (38.3%) or written their advance directives (15%). <h3>Conclusions:</h3> This small survey highlights a practice gap. PD patients are not well informed about palliative care services. Medical teams (including neurology) need to take ownership of the subject and help patients and their families talk about these issues, even if they seem frightening. <b>Disclosure:</b> Dr. Auffret has received personal compensation for serving as an employee of France Développement Electronique. The institution of Dr. Auffret has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Britannia. Dr. Auffret has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Britannia. Dr. Auffret has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Britannia. Dr. Auffret has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Aguettant. The institution of Dr. Auffret has received research support from Association France Parkinson. The institution of Dr. Auffret has received research support from Homeperf. The institution of Dr. Auffret has received research support from LVL. The institution of Dr. Auffret has received research support from University of Rennes 1. The institution of Dr. Auffret has received research support from Aguettant. The institution of Dr. Auffret has received research support from Linde. The institution of Dr. Auffret has received research support from Plateforme Nationale pour la recherche sur la fin de vie. Dr. Auffret has received publishing royalties from a publication relating to health care. Guillaume Robert has nothing to disclose. Matthieu Bereau has nothing to disclose. Mr. Verin has nothing to disclose.

Intraprofessional nursing students coming together through an academic interprofessional practice partnership experience: Are you a caregiver?

An urgent need exists for collaborative intraprofessional clinical and scholarship experiences for DNP and PhD students that allow them to participate in creating unique transferable projects with the potential to improve health for all in our communities. We discussed at a 2018 nursing salon the myriad of informal caregivers who assist with ADLs and/or healthcare management of older adults living at home. Many of these caregivers go unrecognized and may benefit from available community supports to assist them as caregivers. Thus, working with our community experts in geriatrics and case management, home healthcare providers, and nursing faculty, we developed the Are You a Caregiver? Initiative. The purpose was to better identify older adult's informal caregivers and make them aware of available resources in our local community. Our students developed, based on their review of the literature, a combined descriptive caregiver task identifier and community resource infographic. They disseminated it with targeted clinical distribution, and they participated in publishing it on eScholarship. The students participated in identifying and adding to our diverse health care team who reflect our communities served. The next step will be student-led key informant interviews on adapting the infographic to identify/serve hard-to-reach caregivers (immigrant, minority, and/or LGBTQIA+ caregivers). All these clinical and scholarship experiences provided our students with collaborative action-oriented deliverables (including writing for dissemination vs. for presentation only) they can expand on in the future, while experiencing and understanding the unique roles we each play in the creation of interprofessional projects.

Multi-objective home health care routing: a variable neighborhood search method.

Health and convenience are two indispensable indicators of the society promotion. Nowadays, to improve community health levels, the comfort of patients and those in need of health services has received much attention. Providing Home Health Care (HHC) services is one of the critical issues of health care to improve the patient convenience. However, manual nurse planning which is still performed in many HHC institutes results in a waste of time, cost, and ultimately lower efficiency. In this research, a multi-objective mixed-integer model is presented for home health care planning so that in addition to focusing on the financial goals of the institution, other objectives that can help increase productivity and quality of services are highlighted. Therefore, four different objectives of the total cost, environmental emission, workload balance, and service quality are addressed. Taking into account medical staff with different service levels, and the preferences of patients in selecting a service level, as well as different vehicle types, are other aspects discussed in this model. The epsilon-constraint method is implemented in CPLEX to solve small-size instances. Moreover, a Multi-Objective Variable Neighborhood Search (MOVNS) composed of nine local neighborhood moves is developed to solve the practical-size instances. The results of the MOVNS are compared with the epsilon-constraint method, and the strengths and weaknesses of the proposed algorithm are demonstrated by a comprehensive sensitivity analysis. To show the applicability of the algorithm, a real example is designed based on a case study, and the results of the algorithm over real data are evaluated.

Palliative Care across Settings: Perspectives from Inpatient, Primary Care, and Home Health Care Providers and Staff.

Early introduction of palliative care can improve patient-centered outcomes for older adults with complex medical conditions. However, identifying the need for and introducing palliative care with patients and caregivers is often difficult. We aim to identify how and why a multi-setting approach to palliative care discussions may improve the identification of palliative care needs and how to facilitate these conversations. Descriptive qualitative study to inform the development and future pilot testing of a model to improve recognition of, and support for, unmet palliative care needs in home health care (HHC). Thematic analysis of semi-structured interviews with providers across inpatient (n = 11), primary care (n = 17), and HHC settings (n = 10). Four key themes emerged: 1) providers across settings can identify palliative care needs using their unique perspectives of the patient's care, 2) identifying palliative care needs is challenging due to infrequent communication and lack of shared information between providers, 3) importance of identifying a clinical lead of patient care who will direct palliative care discussions (primary care provider), and 4) importance of identifying a care coordination lead (HHC) to bridge communication among multi-setting providers. These themes highlight a multi-setting approach that would improve the frequency and quality of palliative care discussions. A lack of structured communication across settings is a major barrier to introducing and providing palliative care. A novel model that improves communication and coordination of palliative care across HHC, inpatient and primary care providers may facilitate identifying and addressing palliative care needs in medically complex older adults.

PENGALAMAN KELUARGA DALAM MERAWAT PENDERITA OSTEOARTHRITIS

Osteoarthritis is one of the chronic degenerative diseases experienced by the elderly. Various changes that occur in the elderly affect the elderly in responding to the problems they cause. The family as a home health care provider will react to this response. This study aims to explore the experiences of families in caring for osteoarthritis. This study aims to determine the experience of families in caring for patients with osteoarthritis. Using qualitative research methods with a descriptive phenomenological approach, where researchers will describe, describe and describe clearly and in detail and get in-depth data and focus on the issues to be discussed. Participants were taken randomly from several families whose family members suffered from osteoarthritis. The number of participants in this study was nine participants. The results of this study identified two themes: family experience in caring for osteoarthritis sufferers and obstacles or obstacles in caring for osteoarthritis sufferers. It was concluded that the patients with osteoarthritis at home were mainly carried out by the families of the participants, both husbands, wives, and biological children. Experience in caring for people with osteoarthritis carried out by the family includes the family's efforts to overcome the symptoms experienced in osteoarthritis sufferers, experiencing changes in emotional responses, and experiences of support given by families to sufferers of osteoarthritis. Participants also shared their experiences about problems or obstacles experienced by families in caring for people with osteoarthritis and how to deal with these problems, such as experiencing a lack of knowledge in managing people with osteoarthritis and experiencing limitations in caring for people with osteoarthritis.

How Might We Have Known? Using Administrative Data to Predict 30-Day Hospital Readmission in Clients Receiving Home Care Services from 2018 to 2021.

Reducing hospital readmissions can improve individual health outcomes and lower system-level costs. This study aimed to understand the characteristics of home care Personal Support clients who experienced a hospital admission (ie, hospital hold) and to identify factors that predict hospital readmission within 30 days of resuming home care Personal Support services. We conducted a retrospective cohort study using client administrative data from a home healthcare provider organization (2018-2021). The sample included clients (⩾18 years) who received publicly funded Personal Support services and experienced a hospital hold. Descriptive statistics and a binary logistic regression model analyzed the relationship between demographics, hospital service utilization, home care service utilization, and contextual factors on the outcome of 30-day hospital readmission. Approximately 17% (n = 662) of all clients with a hospital hold (n = 3992) were readmitted to hospital within 30 days. Compared with non-readmitted clients, those with greater home care Personal Support service intensity after the index hospital hold were less likely to experience a hospital 30-day readmission. In contrast, those with greater acuity, higher assessed care needs, more hospital holds overall, more extended hospital stays (⩾2 weeks), and lower social support had a higher likelihood of 30-day hospital readmission. The findings from this study provide a greater understanding of factors associated with home care clients' risk of hospital readmission within 30 days and can be used to inform targeted, evidence-based support to reduce home care clients' hospital readmissions.