Depression and increased short-term hospitalization risk among geriatric patients receiving home health care services

Abstract

Objective: This study evaluated the association between depression and hospitalization among geriatric home care patients.

Methods: A sample of 477 patients newly admitted to home care over two years was assessed for depression. Bivariate and logistic regression analyses examined the likelihood of hospitalization during a 60-day home care episode.

Results: The hospitalization rate was similar for the 77 depressed patients and 400 nondepressed patients (about 7%). However, mean time to hospitalization was 8.4 versus 19.5 days after start of care, respectively. Hospitalization risk was significantly higher for depressed patients during the first few weeks. A main effect for depression and a depression-by-time interaction was found when analyses controlled for medical comorbidity, cognitive status, age, gender, race, activities of daily living and instrumental activities of daily living, and referral to home care after hospitalization.

Conclusions: Depression appears to increase short-term risk of hospitalization for geriatric home care patients immediately after starting home care.

Figure 1

Odds of hospitalization associated with depression over timea ^a Figure derived from a logistic regression model including log odds parameters of depression (β=1.29, SE=.61, Wald χ²=4.41, df=1, p=.036), days in care (β=.008, SE=.01, Wald χ²=.35, df=1, p=.553), and the interaction terms (β=−.098, SE=.04, Wald χ²=6.17, df=1, p=.013) and controlling for Mini-Mental State Examination score and medical morbidity