• Joan Gené Badia, Alícia Borràs Santos, Joan Carles Contel Segura, M A Dolors Camprubí Casellas, Francisco Cegri Lombardo, Antonio Heras Tebar, Ramón Noguera Rodríguez, Susana González Martínez, Anna Oliver Olius, Martiño Piñeiro González, Teresa Montanuy Baró, Esther Limón Ramírez, Antonio Aranzana Martínez, Roser Pedret Llaberia, Manuel Borrell Muñoz, and Antonio Hidalgo García.
• Consorci d'Atenció Primària de Salut de l'Eixample (CAPSE), Barcelona, España. jgene@clinic.ub.es
• Gac Sanit. 2011 Jul 1; 25 (4): 308-13.

ObjectiveTo 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.MethodsA 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.ResultsPatients 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.ConclusionsWorkload 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.Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

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