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Linkage of social care and hospital admissions data to explore non-delivery of planned home care for older people in Scotland

Linkage of social care and hospital admissions data to explore non-delivery of planned home care... As part of a pilot studyassessing the feasibility of record-linking health and social care data, the purpose of this paper is to examine patterns of non-delivery of home care among older clients (>65 years) of a social home care provider in Glasgow, Scotland. The paper also assesses whether non-delivery is associated with subsequent emergency hospital admission.Design/methodology/approachAfter obtaining appropriate permissions, the electronic records of all home care clients were linked to a hospital inpatient database and anonymised. Data on home care plans were collated for 4,815 older non-hospitalised clients, and non-delivered visits were examined. Using case-control methodology, those who had an emergency hospital admission in the next calendar month were identified (n=586), along with age and sex-matched controls, to determine whether non-delivery was a risk factor for hospital admission.FindingsThere were 4,170 instances of “No Access” non-delivery among 1,411 people, and 960 instances of “Service Refusal” non-delivery among 427 people. The median number of undelivered visits was two among the one-third of clients who did not receive all their planned care. There were independent associations between being male and living alone, and non-delivery, while increasing age was associated with a decreased likelihood of non-delivery. Having any undelivered home care was associated with an increased risk of emergency hospital admission, but this could be due to uncontrolled confounding.Research limitations/implicationsThis study demonstrates untapped potential for innovative research into the quality of social care and effects on health outcomes.Originality/valueNon-delivery of planned home care, for whatever reason, is associated with emergency hospital admission; this could be a useful indicator of vulnerable clients needing increased surveillance. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Quality in Ageing and Older Adults Emerald Publishing

Linkage of social care and hospital admissions data to explore non-delivery of planned home care for older people in Scotland

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Publisher
Emerald Publishing
Copyright
© Emerald Publishing Limited
ISSN
1471-7794
DOI
10.1108/qaoa-05-2018-0018
Publisher site
See Article on Publisher Site

Abstract

As part of a pilot studyassessing the feasibility of record-linking health and social care data, the purpose of this paper is to examine patterns of non-delivery of home care among older clients (>65 years) of a social home care provider in Glasgow, Scotland. The paper also assesses whether non-delivery is associated with subsequent emergency hospital admission.Design/methodology/approachAfter obtaining appropriate permissions, the electronic records of all home care clients were linked to a hospital inpatient database and anonymised. Data on home care plans were collated for 4,815 older non-hospitalised clients, and non-delivered visits were examined. Using case-control methodology, those who had an emergency hospital admission in the next calendar month were identified (n=586), along with age and sex-matched controls, to determine whether non-delivery was a risk factor for hospital admission.FindingsThere were 4,170 instances of “No Access” non-delivery among 1,411 people, and 960 instances of “Service Refusal” non-delivery among 427 people. The median number of undelivered visits was two among the one-third of clients who did not receive all their planned care. There were independent associations between being male and living alone, and non-delivery, while increasing age was associated with a decreased likelihood of non-delivery. Having any undelivered home care was associated with an increased risk of emergency hospital admission, but this could be due to uncontrolled confounding.Research limitations/implicationsThis study demonstrates untapped potential for innovative research into the quality of social care and effects on health outcomes.Originality/valueNon-delivery of planned home care, for whatever reason, is associated with emergency hospital admission; this could be a useful indicator of vulnerable clients needing increased surveillance.

Journal

Quality in Ageing and Older AdultsEmerald Publishing

Published: Jul 11, 2019

Keywords: Home care; Older adults; Hospital admission; Case-control study; Missed visits; Non-delivery

References