Home based cancer care makes maintaining and supporting patients in their community an important goal from both the individual and delivery system perspectives. Few studies have been done which identify the characteristics that trigger home care referral from inpatient settings. The purpose of this retrospective cross-sectional study was: 1) develop symptom profiles of cancer patients discharged from a tertiary care facility who were referred to home care, 2) identify relationships between home care use and select patient characteristics, 3) determine characteristics predictive of home care referral. The Behavior Model for Health Services Utilization (Aday & Anderson) guided the study. Records were reviewed for 438 admissions (n=287 patients) to a tertiary cancer hospital over a 4-month period. Data were analyzed using qualitative (content analysis) and quantitative (ANOVA, t-test, chi-square, logistic regression) techniques. Eleven symptom categories were identified. Four symptoms were significantly more frequent in patients who were referred to home care: fatigue, edema, dyspnea, constipation. Patients who received home care prior to admission had a significantly greater mean number of symptoms than non-users. Odds of inpatient referral to home care were increased with: 1) having received home care prior to index admission, 2) increasing number of symptoms, and 3) decreased functional independence at hospital discharge. The rapid change in home health care provides an opportunity for public health nurses to establish indicators which identify patients who can benefit from home health care. Study results have implications for benchmarks for quality outcomes and resource consumption in home health care for cancer patients.
Learning Objectives: 1. Describe the symptom profiles of cancer patients who are referred to home care from the inpatient setting 2. List three characteristics that predict home health care referral for patients with cancer 3. Identify relationships between home care use and select patient characteristics
Keywords: Home Care, Cancer
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.