What are the factors that cause emergency home visit in home medical care in Japan?

BACKGROUND

In the home medical care setting, the factors causing emergency home visits (EHV) remain unclear. This study aimed to determine those factors and examine their relationship with EHV requests.

METHODS

This is a single-center retrospective observational study from data obtained from a home medical care clinic. We assessed the association between frequency of EHV and age, gender, level of care-needed, cancer, and medical device in use with using Poisson regression analysis.

RESULTS

A total of 608 EHV in 214 patients were analyzed. Common chief complaints were fever, death, and dyspnea. As factors that affect frequency of EHV because of fever, higher care-needed level (RR: 3.35; 95% CI: 1.95-5.74,  < .001), urinary catheter use (RR: 1.94; 95% CI: 1.22-3.08,  = .005), and central venous port use (RR: 2.39; 95% CI: 1.44-3.96,  = .001) showed significant correlation. Regarding EHV because of dyspnea, lung tumor (RR: 2.71; 95% CI: 1.26-5.84,  = .011) and home oxygen use (RR: 3.96; 95% CI: 2.05-7.68,  < .001) showed significant correlation. Regarding EHV because of all chief complaints, higher care-needed level (RR: 1.59; 95% CI: 1.12-2.26,  = .009), urinary catheter use (RR: 1.78; 95% CI: 1.13-2.93,  = .014), and central venous port use (RR: 1.75; 95% CI: 1.04-2.93,  = .034) showed positive correlation.

CONCLUSION

The factors associated with frequency of EHV because of fever or all chief complaints were urinary catheter use, central venous port use, and higher care-needed level. As for dyspnea, they were lung cancer and home oxygen use. Our study suggests that the burdens on medical staffs, patients, and their families can be reduced through recognizing these risk factors.