scholarly journals Initiation of domiciliary care and nursing home admission following first hospitalization for heart failure, stroke, chronic obstructive pulmonary disease or cancer

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255364
Author(s):  
Rasmus Rørth ◽  
Marianne F. Clausen ◽  
Emil L. Fosbøl ◽  
Ulrik M. Mogensen ◽  
Kristian Kragholm ◽  
...  
Keyword(s):  
Heart Failure ◽  
Nursing Home ◽  
Chronic Diseases ◽  
Nursing Home Care ◽  
Nursing Home Admission ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Domiciliary Care ◽  
Hazard Ratios ◽  
First Time

Background Patients with chronic diseases are at higher risk of requiring domiciliary and nursing home care, but how different chronic diseases compare in terms of risk is not known. We examined initiation of domiciliary care and nursing home admission among patients with heart failure (HF), stroke, COPD and cancer. Methods Patients with a first-time hospitalization for HF, stroke, COPD or cancer from 2008–2016 were identified. Patients were matched on age and sex and followed for five years. Results 111,144 patients, 27,786 with each disease, were identified. The median age was 69 years and two thirds of the patients were men. The 5-year risk of receiving domiciliary care was; HF 20.9%, stroke 25.2%, COPD 24.6% and cancer 19.3%. The corresponding adjusted hazard ratios (HRs), with HF patients used as reference, were: stroke 1.35[1.30–1.40]; COPD 1.29[1.25–1.34]; and cancer 1.19[1.14–1.23]. The five-year incidence of nursing home admission was 6.6% for stroke, and substantially lower in patients with HF(2.6%), COPD(2.6%) and cancer (1.5%). The adjusted HRs were (HF reference): stroke, 2.44 [2.23–2.68]; COPD 1.01 [0.91–1.13] and cancer 0.76 [0.67–0.86]. Living alone, older age, diabetes, chronic kidney disease, depression and dementia predicted a higher likelihood of both types of care. Conclusions In patients with HF, stroke, COPD or cancer 5-year risk of domiciliary care and nursing home admission, ranged from 19–25% and 1–7%, respectively. Patients with stroke had the highest rate of domiciliary care and were more than twice as likely to be admitted to a nursing home, compared to patients with the other conditions.

Relating cause of death with place of care and healthcare costs in the last year of life for patients who died from cancer, chronic obstructive pulmonary disease, heart failure and dementia: A descriptive study using registry data

2017 ◽  
Vol 31 (4) ◽  
pp. 338-345 ◽  
Author(s):  
Annicka GM van der Plas ◽  
Mariska G Oosterveld-Vlug ◽  
H Roeline W Pasman ◽  
Bregje D Onwuteaka-Philipsen
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Nursing Home ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Nursing Home Care ◽  
Chronic Obstructive ◽  
Insurance Company ◽  
Term Care ◽  
Obstructive Pulmonary Disease

Background: The four main diagnostic groups for palliative care provision are cancer, chronic obstructive pulmonary disease, heart failure and dementia. But comparisons of costs and care in the last year of life are mainly directed at cancer versus non-cancer or within cancer patients. Aim: Our aim is to compare the care and expenditures in their last year of life for Dutch patients with cancer, chronic obstructive pulmonary disease, heart failure or dementia. Design: Data from insurance company Achmea (2009–2010) were linked to information on long-term care at home or in an institution, the National Hospital Registration and Causes of Death-Registry from Statistics Netherlands. For patients who died of cancer ( n = 8658), chronic obstructive pulmonary disease ( n = 1637), heart failure ( n = 1505) or dementia ( n = 3586), frequencies and means were calculated, Lorenz curves were drawn up and logistic regression was used to compare patients with high versus low expenditures. Results: For decedents with cancer and chronic obstructive pulmonary disease, the highest costs were for hospital admissions. For decedents with heart failure, the highest costs were for the care home (last 360 days) and hospital admissions (last 30 days). For decedents with dementia, the highest costs were for the nursing home. Conclusion: Patients with dementia had the highest expenditures due to nursing home care. The number of dementia patients will double by the year 2030, resulting in even higher economic burdens than presently. Policy regarding patients with chronic conditions should be informed by research on expenditures within the context of preferences and needs of patients and carers.

scholarly journals Initiation of domiciliary care and nursing home admission following first hospitalization of heart failure patients: a nationwide cohort study

2018 ◽  
Vol Volume 10 ◽  
pp. 917-930 ◽  
Author(s):  
Rasmus Rørth ◽  
Emil L Fosbøl ◽  
Kristian Kragholm ◽  
Ulrik M Mogensen ◽  
Pardeep Jhund ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Nursing Home ◽  
Nursing Home Admission ◽  
Domiciliary Care ◽  
Heart Failure Patients

Socioeconomic differences in outcomes after hospital admission for atrial fibrillation or flutter

2019 ◽  
Author(s):  
Louise Hagengaard ◽  
Mikkel Porsborg Andersen ◽  
Christoffer Polcwiartek ◽  
Jacob Mosgaard Larsen ◽  
Mogens Lytken Larsen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Hospital Discharge ◽  
Disease Rate ◽  
Chronic Obstructive ◽  
Socioeconomic Differences ◽  
Post Discharge ◽  
Obstructive Pulmonary Disease ◽  
Hazard Ratios ◽  
First Time

Abstract Aims To examine socioeconomic differences in care and outcomes in a 1-year period beginning 30 days after hospital discharge for first-time atrial fibrillation or flutter (AF) hospitalization. Methods and results This nationwide register-based follow-up cohort study investigated AF 30-day discharge survivors in Denmark during 2005–2014 and examined associations between patient’s socioeconomic status (SES) and selected outcomes during a 1-year follow-up period beginning 30 days post-discharge after first-time hospitalization for AF. Patient SES was defined in four groups (lowest, second lowest, second highest, and highest) according to each patient’s equivalized income. SES of the included 150 544 patients was: 27.7% lowest (n = 41 648), 28.1% second lowest (n = 42 321), 23.7% second highest (n = 35 656), and 20.5% highest (n = 30 919). Patients of lowest SES were older and more often women. Within 1-year follow-up, patients of lowest SES were less often rehospitalized or seen in outpatient clinics due to AF, or treated with cardioversion or ablation and were slightly more often diagnosed with stroke and heart failure (HF) and significantly more likely to die (16.1% vs. 14.9%, 11.3% and 8.1%). Hazard ratios for all-cause mortality were 0.64 (95% confidence interval 0.61–0.68) for highest vs. lowest SES, adjusted for CHA2DS2-VASc score, chronic obstructive pulmonary disease, rate- and rhythm-controlling drugs, and cohabitation status. Conclusion In 30-day survivors of first-time hospitalization due to AF, lowest SES is associated with increased 1-year all-cause and cardiovascular mortality and fewer cardioversions, ablations, readmissions, and outpatient contacts due to AF. Our findings indicate a need for socially differentiated rehabilitation following hospital discharge for first-time AF.

scholarly journals Chronic obstructive pulmonary disease and heart failure: research and clinical practice in primary care

2015 ◽  
Vol 9 (4) ◽  
pp. 346
Author(s):  
Francesco Chiumeo ◽  
Stefania Folloni
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Diseases ◽  
General Practitioners ◽  
Smoking Status ◽  
Health Care Systems ◽  
International Classification Of Diseases ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

The treatment of chronic obstructive pulmonary disease (COPD) and comorbidities, increasing with age, is the challenge that nowadays health care systems are facing to better care treat these patients. For this reason a clinical trial was conducted in the province of Trento by a group of 30 volunteer general practitioners members of SNAMID (Scientific Society for Continuing Medical Education of General Practitioners). The objectives were to identify: i) prevalence of COPD in patients (65-98 years) in the province of Trento; ii) presence and incidence of heart failure (HF) in COPD patients; iii) early detection of other chronic diseases; and iv) improving electronic medical records (EMR) as an innovation way of professional care management. From May 2011 to October 2013, 17 doctors completed the two-year work using the EMR. The studied patients were men and women (65-98 years), suffering from COPD; the considered data included: anthropometric information, smoking status, International Classification of Diseases (ICD)-9 diagnosis of COPD, HF and chronic diseases, specific blood and instrumental tests. The extracted results were then linked with data of <em>sentinel</em> therapies, collected by the EMR. The database obtained identified patients with COPD or HF not previously recognized with ICD-9 diagnosis. The study identified the <em>sentinel</em> drugs chosen for COPD and HF, excluding other drugs not selective for the study or confusing for a proper statistical evaluation.

Advance care planning in chronic disease: finding the known in the midst of the unknown

2018 ◽  
Author(s):  
Karen Detering ◽  
Elizabeth Sutton ◽  
Scott Fraser
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Advance Care Planning ◽  
Chronic Obstructive ◽  
Care Planning ◽  
Health Care Teams ◽  
Management Options ◽  
Medical Decisions ◽  
Obstructive Pulmonary Disease ◽  
Advance Care

People are living longer lives with a greater burden of disease. Diseases which contribute significantly to this burden are chronic kidney disease; chronic obstructive pulmonary disease and heart failure. Technologies exist that can sustain life for patients with these disease, however patients and their families/loved ones need to know the likely outcome of their disease, its course, and all management options. Advance care planning (ACP) can assist with this process as well as ensuring that patients, families, and health care teams are aware of what treatment a patient wants—or does not want. ACP also enables the appointment of a decision maker to act on behalf of the patient should they lose capacity to make medical decisions. This chapter discusses the benefits of ACP and why it needs to be introduced early in the course of any life-limiting illness.

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