Moger Tron Anders, Holte Jon Helgheim, Amundsen Olav, Haavaag Silje Bjørnsen, Døhl Øystein, Bragstad Line Kildal, Hellesø Ragnhild, Vøllestad Nina Køpke, Tjerbo Trond
Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway.
Department for Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway.
Scand J Prim Health Care. 2025 Mar;43(1):100-110. doi: 10.1080/02813432.2024.2404056. Epub 2024 Sep 16.
Chronic obstructive pulmonary disease (COPD) is a common condition associated with age, multimorbidity and frequently involves the use of health care across levels. Understanding the factors associated with the initiation of long-term care is important when planning the future need for services. We describe healthcare use before and after the reception of any home care. We further studied the associations between healthcare use and first registered home care service and from first registered home care service to nursing home admission or death.
Patients residing in Oslo or Trondheim at the time of first contact with a COPD primary diagnosis, 2009-2018. Patient data were linked across national and municipal registries, covering healthcare and sociodemographics. The sample consisted of 16,738 individuals.
There was a marked increase in inpatient and outpatient hospital contacts in the years prior to and after the reception of any home care. Adjusted for comorbidities and sociodemographics, high numbers of GP consultations, and inpatient and outpatient hospital contacts for respiratory diagnoses were associated with a significantly higher likelihood of receiving home care the next year (hazard odds ratios > 1.3). Following the reception of home care, the type of home care service received (e.g. home nursing or short-term rehabilitation/treatment) was more important than outpatient services in predicting next-year nursing home admission or death.
Including data on prior outpatient care when predicting future need for home care is beneficial. A high frequency (top 10%) of yearly GP, in- or outpatient hospital contacts can imply that the patient may be in need of home care in the near future.
慢性阻塞性肺疾病（COPD）是一种与年龄、多种疾病相关的常见病症，并且经常涉及各级医疗保健的使用。在规划未来的服务需求时，了解与长期护理启动相关的因素非常重要。我们描述了接受任何家庭护理前后的医疗保健使用情况。我们进一步研究了医疗保健使用与首次注册家庭护理服务之间以及从首次注册家庭护理服务到养老院入住或死亡之间的关联。
2009年至2018年首次被诊断为COPD的患者，居住在奥斯陆或特隆赫姆。患者数据通过国家和市政登记处进行关联，涵盖医疗保健和社会人口统计学信息。样本包括16738名个体。
在接受任何家庭护理之前和之后的几年中，住院和门诊医院就诊次数显著增加。在对合并症和社会人口统计学进行调整后，大量的全科医生咨询以及呼吸诊断的住院和门诊医院就诊与次年接受家庭护理的可能性显著更高相关（风险比值比>1.3）。在接受家庭护理之后，所接受的家庭护理服务类型（例如家庭护理或短期康复/治疗）在预测次年养老院入住或死亡方面比门诊服务更重要。
在预测未来家庭护理需求时纳入先前门诊护理的数据是有益的。每年全科医生、住院或门诊医院就诊频率较高（前10%）可能意味着患者在不久的将来可能需要家庭护理。
