Indicators of an Integrated Home Care Model Shaped by the Needs of Patients Discharged from the Emergency Department

Katarzyna Szwamel; Donata Kurpas

doi:10.5334/ijic.5480

Figures & Tables

The scheme of the selection of study participants in ED and GP groups.

Table 1

Structure indicators in ED and GP groups according to one feature of discrete variables.

Feature		GP		ED		Total		Test
Feature		n	%	n	%	n	%	Test
Gender	Female	117	58.5	99	49.5	216	54.0	Chi² = 2.91 df = 1 p = 0.087
Gender	Male	83	41.5	101	50.5	184	46.0	Chi² = 2.91 df = 1 p = 0.087
Total	200	100.0	200	100.0	400	100.0
Education	Primary	14	7.1	17	8.7	31	7.9	Chi² = 1.85 df = 3 p = 0.605
	Vocational	47	24.0	53	27.0	100	25.5
	Secondary	88	44.9	89	45.4	177	45.2
Higher	47	24.0	37	18.9	84	21.4
Total	196	100.0	196	100.0	392	100.0
Marital status	Unmarried	47	23.7	41	20.8	88	22.3	Chi² = 6.95 df = 3 p = 0.074
	Married	116	58.6	116	58.9	232	58.7
	Divorced	7	3.5	19	9.6	26	6.6
Widowed	28	14.1	21	10.7	49	12.4
Total	198	100.0	197	100.0	395	100.0
Financial status	Very bad	2	1.0	0	0.0	2	0.5	Chi² = 7.83 df = 4 p = 0.098
	Bad	9	4.6	14	7.2	23	5.9
	Average	84	42.6	102	52.3	186	47.4
Good	93	47.2	71	36.4	164	41.8
Very good	9	4.6	8	4.1	17	4.3
Total	197	100.0	195	100.0	392	100.0
In a relationship	Yes	129	65.2	140	72.5	269	68.8	Chi² = 2.15 df = 1 p = 0.142
In a relationship	No	69	34.8	53	27.5	122	31.2	Chi² = 2.15 df = 1 p = 0.142
Total	198	100.0	193	100.0	391	100.0
Place of residence	>100 000 inhabitants (city)	12	6.0	15	7.5	27	6.8	Chi² = 8.86 df = 3 p = 0.031
	20 000–100 000 (medium town)	84	42.0	99	49.7	183	45.9
	Less than 20 000 (small town)	15	7.5	24	12.1	39	9.8
Village	89	44.5	61	30.7	150	37.6
Total	200	100.0	199	100.0	399	100.0

[i] Key: n – cardinality, Chi² – chi-square test, p – significance level, df – the number of degrees of freedom.

Table 2

The differences in ED and GP groups regarding the level of meeting needs.

Variable	group	n	M	SD	Me	min	max	test W p	test SW p
Camberwell Index of Needs	GP	200	0.80	0.15	0.83	0.33	1.00	0.008	<0.001
ED	200	0.75	0.19	0.80	0.21	1.00	<0.001

[i] Key: M – average, Me – median, SD – standard deviation, min – minimum, max – maximum, W test: Wilcoxon’s many-one rank test for the difference between medians, SW test – Shapiro-Wilk test, p – the calculated level of test significance, GP – general practice group, ED – emergency department group.

Table 3

Met/unmet needs of ED patients.

No	Needs	Unmet (%)	Met (%)	Total (%)
1	Accommodation	13 (6.50)	187 (93.50)	200 (100)
2	Food and grocery (shopping)	34 (17.00)	166 (83.00)	200 (100)
3	Looking after the home	30 (15.00)	170 (85.00)	200 (100)
4	Self-care at home	33 (18.97)	141 (81.03)	174 (100)
4	Self-care at home	33 (18.97)	141 (81.03)	174 (100)
5	Daytime activities	72 (36.36)	126 (63.64)	198 (100)
6	Physical health	74 (37.56)	123 (62.44)	197 (100)
7	Mental health	45 (33.83)	88 (66.17)	133 (100)
8	Information on condition and treatment	18 (10.71)	150 (89.29)	168 (100)
9	Psychological distress	111 (57.81)	81 (42.19)	192 (100)
10	Drinking alcohol and problems associated with drinking	17 (14.17)	103 (85.83)	120 (100)
11	Narcotics	7 (3.7%)	183 (96.3)	190 (100)
12	Medicines that aren’t prescribed	124 (62.94)	73 (37.06)	197 (100)
13	Social life	38 (19.79)	154 (80.21)	192 (100)
14	Intimate relationships	49 (26.06)	139 (73.94)	188 (100)
15	Satisfaction with intimate relationships	36 (27.69)	94 (72.31)	130 (100)
16	Satisfaction with sexual life	65 (35.71)	117 (64.29)	182 (100)
17	Need of having children	27 (69.23)	12 (30.77)	39 (100)
18	Satisfaction with relationship with children	12 (9.38)	116 (90.63)	128 (100)
19	Possibility of communication by phone	9 (4.59)	187 (95.41)	196 (100)
20	Possibility of using public transport	40 (20.73)	153 (79.27)	193 (100)
21	Ability of budgeting own money	33 (17.19)	159 (82.81)	192 (100)
22	Getting all the money entitled to	25 (12.69)	172 (87.31)	197 (100)

Table 4

The Spearman’s rank correlation ratio (r) for the dependence of the level of needs (Camberwell) from other variables in ED and GP patients group.

Camberwell Index (CI) and variables listed below	Name of variable	GP		ED		GP	ED	r_s1 ≠ r_s2?	Analysis of correspondence
Camberwell Index (CI) and variables listed below	Name of variable	r_s1	p1	r_s2	p2	n1	n2	p3	Analysis of correspondence
Sociodemographic variables
Age	AGE	–0.17	0.015	–0.32	<0.001	200	199	0.113	Yes
Gender	GEN	–0.16	0.021	–0.10	0.148	200	200	0.545	Yes
Education	EDU	0.27	0.000	0.35	<0.001	196	196	0.384	Yes
Marital status	MAR	–0.06	0.407	–0.19	0.008	198	197	0.192	Yes
The number of people living in one household	NPH	0.24	0.001	0.22	0.002	199	198	0.835	Yes
The financial status of the family	FSF	0.30	<0.001	0.35	<0.001	197	195	0.583	Yes
Life in a stable relationship	LSR	–0.25	<0.001	–0.37	<0.001	198	193	0.192	Yes
Place of residence	POR	–0.02	0.800	–0.06	0.427	200	199	0.691
Material status of families	MAT	0,30	<0.001	0.35	<0.001	197	195	0.583	Yes
Variables determining the health profile and the level of health behavior
Treatment of chronic diseases	CHD	0.10	0.150	0.40	<0.001	200	200	0.001	Yes
The number of medication taken regularly per day	NMPD	–0.38	<0.001	–0.41	<0.001	111	96	0.802	Yes
Treatment in a specialist clinic	TSC	0.18	0.012	0.38	<0.001	199	199	0.031	Yes
The number of chronic diseases	NCD	–0.23	0.001	–0.46	<0.001	200	200	0.009	Yes
The number of all hospitalizations within last 3 years	NAH	–0.24	0.001	–0.39	<0.001	200	200	0.097	Yes
The number of ED visits within the last 3 years	NEDV	–0.26	0.014	–0.31	<0.001	86	200	0.677	Yes
Systolic blood pressure – mmHg:	SBP	–0.07	0.319	–0.18	0.011	199	195	0.271	Yes
Diastolic blood pressure – mmHg:	DBP	–0.11	0.124	–0.11	0.119	199	195	1.000
INR	INR	–0.17	0.330	–0.41	0.001	36	67	0.218	Yes
Serum glucose concentration	SGC	–0.16	0.057	–0.26	0.009	136	99	0.434	Yes
Creatinine	CRE	0.01	0.952	–0.27	0.002	102	132	0.032	Yes
BMI	BMI	–0.12	0.092	–0.27	<0.001	198	198	0.123	Yes
IZZ – the increase of health behavior (sum of points)	IZZ	0.49	<0.001	0.17	0.020	187	179	0.001
HEH – healthy eating habits	HEH	0.39	<0.001	0.10	0.175	198	199	0.002	Yes
PB – preventive behavior	PB	0.33	<0.001	0.10	0.168	194	190	0.018	Yes
PMA – positive mental attitude	PMA	0.53	<0.001	0.30	<0.001	199	195	0.006	Yes
HP – health practices	HP	0.28	<0.001	0.01	0.847	192	187	0.007	Yes
Variables concerning the healthcare provided by the general practice personnel
The level of patients’ satisfaction with the case provided by the general practice personnel	SAT	0.38	<0.001	0.14	0.047	200	200	0.010	Yes
Services of the general practice team – realization of house calls	RHC	0.20	0.005	0.14	0.042	200	200	0.540	Yes
Services of the general practice team – providing health education	PHE	0.22	0.002	0.18	0.011	200	200	0.679	Yes
Services of the general practice team – perceiving the GP as a treatment continuator (continuity of treatment)	GPC	0.16	0.025	0.33	<0.001	200	200	0.072	Yes
Variables concerning patients’ convictions and expectations
GSES – General self-efficacy	GSE	0.44	<0.001	0.35	<0.001	200	195	0.292	Yes
MHLC (I) dimension – internal control	MHLC-I	0.00	0.990	0.40	<0.001	193	196	<0.001	Yes
MHLC (O) dimension – influence of others	MHLC-O	–0.09	0.206	0.08	0.298	191	192	0.098
MHLC (A) dimension – accident	MHLC-A	–0.29	<0.001	–0.31	<0.001	195	193	0.830	Yes

[i] Key: GSES – the level of general self-efficacy, GP – general practice, ED – emergency department, MHLC (I) – the positioning of health surveillance in the dimension “internal control,” MHLC (O) – the positioning of health surveillance in the dimension “influence of others,” MHLC (A) – the positioning of health surveillance in the dimension “accident,” INR – international normalized ratio, n1 and n2 – cardinality of observation in the GP and ED group respectively, r_s1 and r_s2 – Spearman’s rank correlation ratio in GP and ED groups, p1 and p2 – the level of significance of the test verifying the null hypothesis (r = 0) in reference to the alternative that it is other than zero (r ≠ 0), p3 – the level of significance of the test verifying the null hypothesis stating that the correlation ratio r_s1 and r_s2 are equal (r_s1 = r_s2) in reference to the alternative that it is other than zero (r_s1 ≠ r_s2).

Indicators of an integrated home care model shaped by the needs of general practice patients.

Table 5

The quotient of chances of hospitalization in the ED and GP groups in relation to the level of the satisfaction of patients’ needs.

3-year hospitalization
Variable	Me	No		Yes		OR	p
Variable	Me	n	%	N	%	CI1	CI2
GP group
Camberwell Index of Needs	≤0.83	53	51	51	49	0.33	<0.001
>0.83	73	76	23	24	0.17	0.62
ED group
Camberwell Index of Needs	≤0.80	36	35	67	65	0.28	<0.001
>0.80	64	66	33	34	0.15	0.52

[i] Key: Me – median, p – the calculated level of significance of the Fisher’s accurate dependence test, OR – odds ratio, CI1 and CI2 – borders of 95% confidence interval for OR.

Indicators of an Integrated Home Care Model Shaped by the Needs of Patients Discharged from the Emergency Department

Figures & Tables

Figure 1

Table 1

Table 2

Table 3

Table 4

Figure 2

Table 5

Paradigm

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