[Home care effectiveness assessment in a health maintenance organization in Belo Horizonte, Minas Gerais State, Brazil].
A retrospective cohort study was performed to assess the impact of a Case Management Home Care Program supplied by the Unimed-BH medical cooperative on hospitalization-free survival time among eligible patients 60 years or older. A Cox proportional hazards model was fitted to assess the impact of home visits by health professionals on hospitalization-free survival time in a sample of 2,943 elders, while adjusting for patient age, physical dependence, medicines, feeding route, pressure ulcers, supplemental oxygen therapy, cognitive impairment, outpatient visits, and hospitalizations in the preceding quarter. Risk factors for shorter hospitalization-free survival time were: degree of physical dependence, enteral nutrition, supplemental oxygen therapy, pressure ulcers, and hospital admissions in the previous quarter. Higher rates of home visits by physicians and nurses showed a protective dose-response effect on hospitalization-free survival time. The data suggest that regular home visits by physicians and nurses lengthen hospitalization-free survival time among elderly patients enrolled in the program.
Gestão de Epidemiologia de Serviços de Saúde, Unimed, Belo Horizonte, Brasil.
Fernando Martín
FM
Biscione
Gestão de Epidemiologia de Serviços de Saúde, Unimed, Belo Horizonte, Brasil.
Daniele Araújo Campos
DA
Szuster
Gestão de Epidemiologia de Serviços de Saúde, Unimed, Belo Horizonte, Brasil.
Eliane de Freitas
Ede F
Drumond
Gestão de Epidemiologia de Serviços de Saúde, Unimed, Belo Horizonte, Brasil.
Graziele Umbelina Alves
GU
Ferreira
Superintendência de Serviços Próprios, Unimed, Belo Horizonte, Brasil.
Maria Aparecida
MA
Turci
Gestão de Epidemiologia de Serviços de Saúde, Unimed, Belo Horizonte, Brasil.
Jorge Faria
JF
Lima
Superintendência de Provimento de Saúde, Unimed, Belo Horizonte, Brasil.
Sérgio Adriano Loureiro
SA
Bersan
D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D015331:Cohort Studies; D005260:Female; D006279:Health Maintenance Organizations / Q000592:standards*; D006299:Health Services for the Aged / Q000592:standards*; D006699:Home Care Services / Q000592:standards* / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D012189:Retrospective Studies; D013997:Time Factors