title: Nursing workload predictors in Catalonia (Spain): a home care cohort study.
abstract: OBJECTIVE
  To identify the characteristics of chronic patients and their environment in order to predict the nursing workload required 1 year after their inclusion in a home care program.
  
  
  METHODS
  A longitudinal study was carried out in 72 primary health care teams in Catalonia (Spain) with a 1-year follow-up of 1,068 home care patients over 64 years old. The variables collected from each patient included data on health and social status (Charlson and Barthel indexes and the Pfeiffer, Braden and Gijon scales), carer overburden (Zarit scale), hospital admissions, use of emergency services, self-perceived health (SF-12) and the number of health worker visits.
  
  
  RESULTS
  Patients received 7.2 (SD 10.4) visits per year from their nurse-in-charge, out of a total of 8.7 (SD 13.1) nursing visits per year. Risk factors for receiving more nursing visits at home were male gender (IRR=1.42, 95%CI: 1.20-1.67), dependency for daily activities (IRR=1.65, 95%CI: 1.29-2.13), decubitus ulcers (IRR=4.03, 95%CI: 2.27-7.14) and receiving emergency medical care at home (IRR=1.65, 95%CI: 1.31-2.07). In contrast, patients with major cognitive impairment (IRR=0.78, 95%CI: 0.63-0.98) had a lower probability of receiving nursing visits at home.
  
  
  CONCLUSIONS
  Workload can be predicted by patients' clinical characteristics. The positive correlation of workload with variables related to disease severity and the negative correlation with variables related to cognitive impairment show that home care nursing in Catalonia is basically demand-oriented.
authors.affiliation: Consorci d'Atenció Primària de Salut de l'Eixample (CAPSE), Barcelona, España. jgene@clinic.ub.es
authors.forename: Joan
authors.initials: J
authors.lastname: Gené Badia
authors.forename: Alícia
authors.initials: A
authors.lastname: Borràs Santos
authors.forename: Joan
authors.initials: J
authors.lastname: Carles Contel Segura
authors.forename: M A Dolors
authors.initials: MA
authors.lastname: Camprubí Casellas
authors.forename: Francisco
authors.initials: F
authors.lastname: Cegri Lombardo
authors.forename: Antonio
authors.initials: A
authors.lastname: Heras Tebar
authors.forename: Ramón
authors.initials: R
authors.lastname: Noguera Rodríguez
authors.forename: Susana
authors.initials: S
authors.lastname: González Martínez
authors.forename: Anna
authors.initials: A
authors.lastname: Oliver Olius
authors.forename: Martiño
authors.initials: M
authors.lastname: Piñeiro González
authors.forename: Teresa
authors.initials: T
authors.lastname: Montanuy Baró
authors.forename: Esther
authors.initials: E
authors.lastname: Limón Ramírez
authors.forename: Antonio
authors.initials: A
authors.lastname: Aranzana Martínez
authors.forename: Roser
authors.initials: R
authors.lastname: Pedret Llaberia
authors.forename: Manuel
authors.initials: M
authors.lastname: Borrell Muñoz
authors.forename: Antonio
authors.initials: A
authors.lastname: Hidalgo García
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000451:nursing; D003072:Cognition Disorders / Q000451:nursing; D015897:Comorbidity; D003858:Dependency, Psychological; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006304:Health Status; D006699:Home Care Services / Q000706:statistics & numerical data*; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D003668:Pressure Ulcer / Q000451:nursing; D012923:Social Class; D013030:Spain; D016526:Workload / Q000706:statistics & numerical data*