https://orcid.org/0000-0002-1161-8354
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Abstract
Objective
This study aimed to 1) report the prevalence of chronic conditions among Saudi people receiving long-term home health care (HHC) services, 2) identify the predictors of mortality among individuals receiving long-term HHC services, and 3) study the association between frailty and poor health outcomes among HHC users.
Design
Retrospective cross-sectional descriptive study.
Setting and Participants
A total of 555 participants were recruited from HHC services at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia. We collected the data from electronic health records (EHR), patient charts, and caregiver interviews for 555 participants included in HHC program from the year 2019 to 2022.
Methods
Only individuals fulfilling the HHC program’s eligibility criteria were included to the study. A total of 555 participants were included in the analysis. We assessed the functional performance by the Katz activity of daily living and Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). We calculated the means and frequency to describe the prevalence of chronic conditions and variables of interest. A Chi-square test or independent-samples t-test was run to determine if there were differences between the alive and deceased individuals. A binary logistic regression model was performed to predict mortality of HHC service recipients.
Results
The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. We found that the strongest predictors for mortality were pressure ulcers with an odds ratio of 3.75 and p-value of <0.0001, and the Clinical Frailty Scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis.
Conclusions and Implications
In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services.
Abbreviations
HHC, Home Health Care; MOH, Ministry Of Health; HER, Electronic Health Records; BADLS, Bristol Activity of Daily Living Scale; CFS, Clinical Frailty Scale.
Data Sharing Statement
Data are available upon reasonable request to the corresponding author.
Ethics Committee Approval
Human Research Ethics Committee approval was provided by the King Saud University (KSU) Institutional Review Board, reference number 21/0697/IRB project number KSU-IRB 017E, informed consent is waived for retrospective study based on our institutional policies. Data were anonymized before secured storage. This study was performed in compliance with the Declaration of Helsinki.
Acknowledgment
We would like to acknowledge Mrs. Irene Bueno, Mr. Arthur Rico, Mr. Ralph Jason Bucaneg for their assistance in the data collection and their great care of the clients of HHC at KSUMC.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.