Predictors of Mortality in Home Health Care Service: Data from Saudi Arabia

Abstract

Walid A Alkeridy,1– 3 Arwa Aljasser,4 Khalid Mohammed Alayed,1 Saad M Alsaad,5 Amani S Alqahtani,6 Claire Ann Lim,7 Sultan H Alamri,8,9 Doaa Zainhom Mekkawy,1 Mohammed Al-Sofiani1,10 1Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Department of Medicine, Geriatric Division, University of British Columbia, Vancouver, Canada; 3General Administration of Home Health Care, Therapeutic Affairs Deputyship, Riyadh, Saudi Arabia; 4Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 5Department of Family & Community medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 6Research department, Saudi Food and Drug Authority, Riyadh, Saudi Arabia; 7Department of Medical Rehabilitation, King Saud Medical City, Riyadh, Saudi Arabia; 8Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 9Saudi Geriatrics Society, Riyadh, Saudi Arabia; 10Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins University, Baltimore, MD, USACorrespondence: Walid A Alkeridy, West College of Medicine Building, 3rd Floor, Riyadh, Riyadh, 12372, Saudi Arabia, Tel [phone], Email [email protected]: This study aimed to 1) report the prevalence of chronic conditions among Saudi people receiving long-term home health care (HHC) services, 2) identify the predictors of mortality among individuals receiving long-term HHC services, and 3) study the association between frailty and poor health outcomes among HHC users.Design: Retrospective cross-sectional descriptive study.Setting and Participants: A total of 555 participants were recruited from HHC services at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia. We collected the data from electronic health records (EHR), patient charts, and caregiver interviews for 555 participants included in HHC program from the year 2019 to 2022.Methods: Only individuals fulfilling the HHC program’s eligibility criteria were included to the study. A total of 555 participants were included in the analysis. We assessed the functional performance by the Katz activity of daily living and Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). We calculated the means and frequency to describe the prevalence of chronic conditions and variables of interest. A Chi-square test or independent-samples t-test was run to determine if there were differences between the alive and deceased individuals. A binary logistic regression model was performed to predict mortality of HHC service recipients.Results: The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. We found that the strongest predictors for mortality were pressure ulcers with an odds ratio of 3.75 and p-value of < 0.0001, and the Clinical Frailty Scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis.Conclusions and Implications: In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services.Keywords: home health care, Saudi Arabia, predictors of mortality

Keywords

• home health care
• saudi arabia
• predictors of mortality