Morbilidad y uso de recursos de las personas incluidas en el programa de atención domiciliaria de la atención primaria

Abstract

Objective: To describe health status and health care services of the people included in home care program (HC) through secondary use of data from the public system. Design: Observational population-based study. Location: Primary health care in Catalonia (2022). Participants: All people over 65 years of age included in HC matched 1:1 with people not attended in HC by age, sex, socioeconomic level and primary care team (45,578 persons per group, 70.5% women and mean age 86.8 years). Interventions: People receiving HC. Main measurements: Morbidity, healthcare use and events (hospital admissions, mortality) Results: 53.6% of people in HC had a diagnosis of complex chronic patient and 5.7% of advanced chronic disease, compared to 1.1% and 0.05% in the non-HC population. There were more people in HC with heart failure, dementia, stroke, auricular fibrillation and COPD, with higher drug use and pharmaceutical expenditure ( 1,446 vs. 732, ratio 1.98, 95%CI 1.95-2.00). Mortality was 20% in HC and 6% in the non-HC population (ratio 3.3, 95%CI 3.17-3.44). A stratified analysis by age showed a higher complexity, morbidity and events in people between 65 and 80 years of age with respect to those over 80 years of age in HC. Conclusions: The results, which show increased morbidity and complexity in HC, especially in people under 80 years of age, may be useful to better identify care needs of these people and program planning. (c) 2025 The Authors. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).