Determinants of Unplanned Emergency Department Utilization Among Home Care Clients: Predictors Beyond Person-Level Need

THE PROBLEM

As Ontario’s population ages and suffers an increasing burden of morbidity and functional impairment, the health care system must also shift to address their needs. It is recognized that the current burden on hospitals and long-term care facilities is unsustainable, and home care services are being turned to as an approach that will hopefully provide both optimal health outcomes as well as a sustainable method of delivering care. It is thought that by supporting individuals in the community, they will remain functionally independent and healthier within their native setting. While home care services have been employed for decades, how much they impact health service usage and health outcomes – and the subsequent development of an evidence-based approach to optimization – is unclear.  Efforts thus far have focused on a high risk population and have had mixed results, whereas the impact on average risk individuals is unknown.

Our approach

We will use the Health Outcome for Better Information and Care (HOBIC) and Discharge Abstract Database (DAD) databases to identify a cohort of patients aged 65+ that were discharged from the hospital back into the community with or without home care services. The identified cohort will be linked to administrative health databases (e.g., National Ambulatory Care Reporting System Metadata (NACRS), DAD) to examine various clinical outcomes.

Our Team

Team Leads:

Andrew P. Costa, PhD | McMaster University

Susan Bronskill, MSc, PhD | IC/ES - Central

Operations Team:

Ahmad Rahim, MSc. | Analyst | IC/ES - McMaster University

Mats Junek, MSc. (c), MD | McMaster University

Investigators:

Susan Bronskill, MSc, PhD | IC/ES-Central


Partners

Institute for Clinical Evaluative Sciences

Institute for Clinical Evaluative Sciences