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Home Healthcare Patients With Distinct Psychological, Cognitive, and Behavioral Symptom Profiles and At-Risk Subgroup for Hospitalization and Emergency Department Visits Using Latent Class Analysis
Journal article   Peer reviewed

Home Healthcare Patients With Distinct Psychological, Cognitive, and Behavioral Symptom Profiles and At-Risk Subgroup for Hospitalization and Emergency Department Visits Using Latent Class Analysis

Se Hee Min, Jiyoun Song, Lauren Evans, Kathryn H. Bowles, Margaret V. McDonald, Sena Chae and Maxim Topaz
Clinical nursing research, Vol.32(7), pp.1021-1030
09/2023
DOI: 10.1177/10547738231183026
PMCID: PMC11080676
PMID: 37345951
url
https://pmc.ncbi.nlm.nih.gov/articles/PMC11080676/pdf/nihms-1982224.pdfView
Open Access

Abstract

One-third of home healthcare patients are hospitalized or visit emergency departments during a 60-day episode of care. Among all risk factors, psychological, cognitive, and behavioral symptoms often remain underdiagnosed or undertreated in older adults. Little is known on subgroups of older adults receiving home healthcare services with similar psychological, cognitive, and behavioral symptom profiles and an at-risk subgroup for future hospitalization and emergency department visits. Our cross-sectional study used data from a large, urban home healthcare organization (n = 87,943). Latent class analysis was conducted to identify meaningful subgroups of older adults based on their distinct psychological, cognitive, and behavioral symptom profiles. Adjusted multiple logistic regression was used to understand the association between the latent subgroup and future hospitalization and emergency department visits. Descriptive and inferential statistics were conducted to describe the individual characteristics and to test for significant differences. The three-class model consisted of Class 1: “Moderate psychological symptoms without behavioral issues,” Class 2: “Severe psychological symptoms with behavioral issues,” and Class 3: “Mild psychological symptoms without behavioral issues.” Compared to Class 3, Class 1 patients had 1.14 higher odds and Class 2 patients had 1.26 higher odds of being hospitalized or visiting emergency departments. Significant differences were found in individual characteristics such as age, gender, race/ethnicity, and insurance. Home healthcare clinicians should consider the different latent subgroups of older adults based on their psychological, cognitive, and behavioral symptoms. In addition, they should provide timely assessment and intervention especially to those at-risk for hospitalization and emergency department visits.
 Aging Mental Health home healthcare cognition patient outcome

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