Background
Methods
Study Design
Data sources
-
Hospital discharge records of S. G. Bosco Hospital containing International Classification of Diseases IX-Clinical Modification (ICD IX-CM) pathology codes and readmissions date;
-
Data on discharge planning of the Operative Care Centre of Local Health Unit N°4 of Turin containing demographic variables (gender, age, etc) as well as physical and mental disability scales, such as ADL, IADL, and SPMSQ;
-
Data from the registrar's office of the municipality of Turin in order to verify deaths and date of event;
-
Data from the social services of the municipality of Turin containing social variables (family network, pension, etc).
Statistical analyses
Ethics
Results
DPCH | ||||
---|---|---|---|---|
Routine care | Followed by LTCI | Not followed by LTCI | p-value (Chi-square test) | |
n = 107 | n = 99 | n = 174 | ||
Gender
| ||||
Female
| 59 (55.1%) | 66 (66.7%) | 108 (62.1%) | 0.228 |
Male
| 48 (44.9%) | 33 (33.3%) | 66 (37.9%) | |
Age (years)
| ||||
64–74
| 34 (31.8%) | 20 (20.2%) | 23 (13.2%) | 0.003 |
75–84
| 39 (36.4%) | 42 (42.4%) | 93 (53.4%) | |
85+
| 34 (31.8%) | 37 (37.4%) | 58 (33.3%) | |
Living arrangement
| ||||
Living alone
| 44 (41.1%) | 51 (51.5%) | 91 (52.3%) | 0.427 |
Living with at least a relative
| 48 (44.9%) | 35 (35.4%) | 63 (36.2%) | |
Caregiver
| 15 (14.0%) | 13 (13.1%) | 20 (11.5%) | |
Pension
| ||||
<750 euro
| 63 (58.9%) | 51 (51.5%) | 113 (65.3%) | 0.08 |
≥ 750 euro
| 44 (41.1%) | 48 (48.5%) | 60 (34.7%) | |
Primary diagnosis at admission
| ||||
Cardio-circulatory diseases
| 26 (24.3%) | 26 (26.3%) | 46 (26.4%) | <0.001 |
Injury and poisonings
| 7 (6.5%) | 19 (19.2%) | 44 (25.3%) | |
Cancers
| 31 (29.0%) | 9 (9.1%) | 14 (8.0%) | |
Diseases of the respiratory system
| 9 (8.4%) | 10 (10.1%) | 21 (12.1%) | |
Diseases of the digestive system
| 6 (5.6%) | 7 (7.1%) | 14 (8.0%) | |
Other diseases
| 28 (26.2%) | 28 (28.3%) | 35 (20.1%) | |
ADL at hospital admission
| ||||
Independent
| 10 (9.3%) | 15 (15.3%) | 12 (7.0%) | <0.001 |
Partially dependent
| 55 (51.4%) | 79 (80.6%) | 135 (78.9%) | |
Totally dependent
| 42 (39.3%) | 4 (4.1%) | 24 (14.0%) | |
IADL at hospital admission
| ||||
Independent
| 6 (5.6%) | 13 (13.3%) | 23 (13.4%) | 0.001 |
Partially dependent
| 33 (30.8%) | 50 (51.0%) | 57 (33.1%) | |
Totally dependent
| 68 (63.6%) | 35 (35.7%) | 92 (53.5%) | |
Cognitive deterioration
| ||||
Absent-light
| 76 (71.0%) | 79 (79.8%) | 127 (73.4%) | 0.165 |
Moderate
| 22 (20.6%) | 18 (18.2%) | 29 (16.8%) | |
Severe
| 9 (8.4%) | 2 (2.0%) | 17 (9.8%) |
DPCH | ||||
---|---|---|---|---|
Routine care | Followed by LTCI | Not followed by LTCI | p-value (Log-Rank test*) | |
49 (45.8%) | 10 (10.1%) | 39 (22.4%) | ||
Gender
| ||||
Female
| 22 (37.3%) | 4 (6.1%) | 18 (16.7%) | 0.002 |
Male
| 27 (56.3%) | 6 (18.2%) | 21 (31.8%) | |
Age (years)
| ||||
64–74
| 18 (52.9%) | 1 (5.0%) | 3 (13.0%) | 0.488 |
75–84
| 18 (46.2%) | 4 (9.5%) | 19 (20.4%) | |
85+
| 13 (38.2%) | 5 (13.5%) | 17 (29.3%) | |
Living arrangement
| ||||
Living alone
| 20 (45.5%) | 5 (9.8%) | 17 (18.7%) | 0.570 |
Living with at least a relative
| 25 (52.1%) | 3 (8.6%) | 17 (27.0%) | |
Caregiver
| 4 (26.7%) | 2 (15.4%) | 5 (25.0%) | |
Pension
| ||||
<750 euro
| 28 (44.4%) | 4 (7.8%) | 26 (23.0%) | 0.751 |
≥ 750 euro
| 21 (47.7%) | 6 (12.5%) | 13 (21.7%) | |
Primary diagnosis at admission
| ||||
Cardio-circulatory diseases
| 11 (42.3%) | 2 (7.7%) | 6 (13.0%) | <0.001 |
Injury and poisonings
| 0 (0.0%) | 1 (5.3%) | 8 (18.2%) | |
Cancers
| 24 (77.4%) | 2 (22.2%) | 7 (50.0%) | |
Diseases of the respiratory system
| 3 (33.3%) | 1 (10.0%) | 8 (38.1%) | |
Diseases of the digestive system
| 2 (33.3%) | 1 (14.3%) | 2 (14.3%) | |
Other diseases
| 9 (32.1%) | 3 (10.7%) | 8 (22.9%) | |
ADL at hospital admission
| ||||
Independent
| 4 (40.0%) | 1 (6.7%) | 3 (25.0%) | 0.030 |
Partially dependent
| 26 (47.3%) | 7 (8.9%) | 27 (20.0%) | |
Totally dependent
| 19 (45.2%) | 1 (25%) | 9 (37.5%) | |
IADL at hospital admission
| ||||
Independent
| 1 (16.7%) | 1 (7.7%) | 3 (13.0%) | 0.324 |
Partially dependent
| 21 (63.6%) | 3 (6.0%) | 15 (26.3%) | |
Totally dependent
| 27 (39.7%) | 5 (14.3%) | 21 (22.8%) | |
Cognitive deterioration
| ||||
Absent-light
| 34 (44.7%) | 8 (10.1%) | 28 (22.0%) | 0.603 |
Moderate
| 13 (59.1%) | 2 (11.1%) | 6 (20.7%) | |
Severe
| 2 (22.2%) | 0 (0.0%) | 5 (29.4%) |
DPCH | ||||
---|---|---|---|---|
Routine care | Followed by LTCI | Not followed by LTCI | p-value (Log-Rank test*) | |
29 (27.1%) | 22 (22.2%) | 33 (19.0%) | ||
Gender
| ||||
Female
| 17 (28.8%) | 11 (16.7%) | 18 (16.7%) | 0.129 |
Male
| 12 (25.0%) | 11 (33.3%) | 15 (22.7%) | |
Age (years)
| ||||
64–74
| 8 (23.5%) | 4 (20.0%) | 2 (8.7%) | 0.074 |
75–84
| 12 (30.8%) | 12 (28.6%) | 21 (22.6%) | |
85+
| 9 (26.5%) | 6 (16.2%) | 10 (17.2%) | |
Living arrangement
| ||||
Living alone
| 16 (36.4%) | 10 (19.6%) | 17 (18.7%) | 0.393 |
Living with at least a relative
| 9 (18.8%) | 9 (25.7%) | 12 (19.0%) | |
Caregiver
| 4 (26.7%) | 3 (23.1%) | 4 (20.0%) | |
Pension
| ||||
<750 euro
| 14 (22.2%) | 11 (21.6%) | 23 (20.4%) | 0.472 |
≥ 750 euro
| 15 (34.1%) | 11 (22.9%) | 10 (16.7%) | |
Primary diagnosis at admission
| ||||
Cardio-circulatory diseases
| 11 (42.3%) | 4 (15.4%) | 7 (15.2%) | 0.256 |
Injury and poisonings
| 3 (42.9%) | 4 (21.1%) | 2 (4.5%) | |
Cancers
| 6 (19.4%) | 0 (0.0%) | 4 (28.6%) | |
Diseases of the respiratory system
| 3 (33.3%) | 4 (40.0%) | 7 (33.3%) | |
Diseases of the digestive system
| 1 (16.7%) | 3 (42.9%) | 4 (28.6%) | |
Other diseases
| 5 (17.9%) | 7 (25.0%) | 9 (25.7%) | |
ADL at hospital admission
| ||||
Independent
| 3 (30.0%) | 2 (13.3%) | 2 (16.7%) | 0.360 |
Partially dependent
| 17 (30.9%) | 19 (24.1%) | 27 (20.0%) | |
Totally dependent
| 9 (21.4%) | 1 (25.0%) | 4 (16.7%) | |
IADL at hospital admission
| ||||
Independent
| 2 (33.3%) | 4 (30.8%) | 2 (8.7%) | 0.162 |
Partially dependent
| 8 (24.2%) | 11 (22.0%) | 17 (29.8%) | |
Totally dependent
| 19 (27.9%) | 6 (17.1%) | 14 (15.2%) | |
Cognitive deterioration
| ||||
Absent-light
| 20 (26.3) | 15 (19.0%) | 24 (18.9%) | 0.103 |
Moderate
| 7 (31.8) | 6 (33.3%) | 4 (13.8%) | |
Severe
| 2 (22.2) | 1 (50.0%) | 5 (29.4%) |
HR | 95% CI | |
---|---|---|
Gender
| ||
Female
| 1 | |
Male
| 1.44 | 1.00–2.09 |
Age (years)
| ||
64–74
| 1 | |
75–84
| 0.77 | 0.48–1.26 |
85+
| 1.12 | 0.69–1.83 |
Primary diagnosis at admission
| ||
Cardio-circulatory diseases
| 1 | |
Injury and poisonings
| 0.62 | 0.31–1.25 |
Cancers
| 3.27 | 1.93–5.55 |
Diseases of the respiratory system
| 1.84 | 1.01–3.34 |
Diseases of the digestive system
| 1.27 | 0.54–2.99 |
Other diseases
| 0.94 | 0.55–1.63 |
ADL at hospital admission
| ||
Independent
| 1 | |
Partially dependent
| 0.57 | 0.26–1.24 |
Totally dependent
| 0.7 | 0.30–1.64 |
IADL at hospital admission
| ||
Independent
| 1 | |
Partially dependent and Totally dependent
| 2.02 | 0.79–5.21 |
Typology of term-care
| ||
Routine care
| 1 | |
Care home not followed by long term care intervention
| 1.15 | 0.77–1.74 |
Care home followed by long term care intervention
| 0.36 | 0.20–0.66 |
P-value of log partial likelihood ratio test <0.001 |
HR | 95% CI | |
---|---|---|
Gender
| ||
Female
| 1 | |
Male
| 1.43 | 0.94–2.16 |
Age (years)
| ||
64–74
| 1 | |
75–84
| 1.4 | 0.81–2.40 |
85+
| 0.9 | 0.49–1.65 |
Living arrangement
| ||
Living alone
| 1 | |
Living with at least a relative or caregiver
| 0.72 | 0.48–1.10 |
Primary diagnosis at admission
| ||
Cardio-circulatory diseases
| 1 | |
Injury and poisonings
| 0.83 | 0.43–1.62 |
Cancers
| 0.99 | 0.49–2.00 |
Diseases of the respiratory and digestive systems
| 1.69 | 0.97–2.96 |
Other diseases
| 0.99 | 0.57–1.72 |
IADL at hospital admission
| ||
Independent
| 1 | |
Partially dependent
| 1.47 | 0.70–3.07 |
Totally dependent
| 1.01 | 0.48–2.14 |
Cognitive deterioration
| ||
Absent-light
| 1 | |
Moderate
| 1.31 | 0.78–2.17 |
Severe
| 2.2 | 1.09–4.43 |
Typology of term-care
| ||
Routine care
| 1 | |
Care home not followed by long term care intervention
| 1.18 | 0.71–1.96 |
Care home followed by long term care intervention
| 1.01 | 0.48–2.14 |
P-value of log partial likelihood ratio test = 0.049 |