title: Factors associated with unexpected admissions and mortality among low-functioning older patients receiving home medical care.
abstract: OBJECTIVE
  The need for and availability of home medical care for elderly patients with limitations in terms of access to medical facilities has been increasing. We investigated the association between low function, malnutrition, dementia and multicomorbidity with patient prognosis, focusing on unexpected hospital admissions and mortality in elderly non-cancer patients receiving home care.
  
  
  METHODS
  The study included 124 Japanese patients receiving home medical care in the form of regular visits from doctors and nurses for physical and/or mental disability.
  
  
  RESULTS
  Of the patients studied, 36.2% experienced hospital admission. Student's t-test showed that admitted patients had significantly higher Charlson Comorbidity Index scores. Meanwhile, 19.6% of patients died during the course of the study. Student's t-test showed that older patients had a higher risk of mortality, and significantly lower activities of daily living and Mini-Nutritional Assessment Short-Form scores. Cox hazard analysis showed that multicomorbidity was a risk for unexpected hospital admission, and malnutrition was a risk for mortality in frail older adults receiving home medical care.
  
  
  CONCLUSIONS
  We found that multicomorbidity was a risk for unexpected hospital admission, and malnutrition was a risk for mortality in frail older adults receiving home medical care. Geriatr Gerontol Int 2017; 17: 1623-1627.
authors.affiliation: Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Umegaki
authors.affiliation: Sanei Clinic, Komaki, Aichi, Japan.
authors.forename: Atushi
authors.initials: A
authors.lastname: Asai
authors.affiliation: Minami Health-Medical Cooperative Kaname Hospital, Nagoya, Aichi, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kanda
authors.affiliation: Department of Home Medical Care, Mokuren Clinic, Nagoya, Aichi, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Kachigawa Family Clinic, Kasugai, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Shimojima
authors.affiliation: Aichi Clinic, Nagoya, Aichi, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Nomura
authors.affiliation: Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kuzuya
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000150:complications* / Q000401:mortality; D005260:Female; D016330:Frail Elderly; D000073496:Frailty / Q000150:complications* / Q000401:mortality; D015577:Geriatric Assessment; D006699:Home Care Services; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000401:mortality; D011379:Prognosis
keywords: basic activities of daily life; comorbidity; dementia; hospital admission; nutrition