ArticleJournal of pain and symptom management2016
Association Between Symptom Burden and Time to Hospitalization, Nursing Home Placement, and Death Among the Chronically Ill Urban Homebound.
Article in Journal of pain and symptom management, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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Who cites it
7 citing papers in PubMed.
- Subjective geriatric complaints as predictors of disability and mortality in community-dwelling older adults: a 5-year cohort study.Age and ageing · 2025Article
- Changes in symptom burden from 2019 to 2021 amongst community-dwelling older adults in Finland.Age and ageing · 2023Article
- Symptom burden in community-dwelling older people: temporal trends in the Helsinki Aging Study.Aging clinical and experimental research · 2021Article
- The Association of Advance Care Planning Documentation and End-of-Life Healthcare Use Among Patients With Multimorbidity.The American journal of hospice & palliative care · 2021Article
- Homebound: A concept analysis.Nursing forum · 2021Article
- Palliative Care Symptoms, Outcomes, and Interventions for Chronic Advanced Patients in Spanish Nursing Homes with and without Dementia.International journal of environmental research and public health · 2020Article
- Self-regulatory coping among community dwelling older adults with multiple chronic conditions.Journal of multimorbidity and comorbidityArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
contextHomebound adults experience significant symptom burden.
objectivesTo examine demographic and clinical characteristics associated with high symptom burden in the homebound, and to examine associations between symptom burden and time to hospitalization, nursing home placement, and death.
methodsThree hundred eighteen patients newly enrolled in the Mount Sinai Visiting Doctors Program, an urban home-based primary care program, were studied. Patient sociodemographic characteristics, symptom burden (measured via the Edmonton Symptom Assessment Scale), and incidents of hospitalization, nursing home placement, and death were collected via medical chart review. Multivariate Cox proportional hazards models were used to analyze the effect of high symptom burden on time to first hospitalization, nursing home placement, and death.
resultsOf the study sample, 45% had severe symptom burden (i.e., Edmonton Symptom Assessment Scale score >6 on at least one symptom). Patients with severe symptom burden were younger (82.0 vs. 85.5 years, P < 0.01), had more comorbid conditions (3.2 vs. 2.5 Charlson score, P < 0.01), higher prevalence of depression (43.4% vs. 12.0%, P < 0.01), lower prevalence of dementia (34.3% vs. 60.6%, P < 0.01), and used fewer hours of home health services (73.6 vs. 94.4 hours/wk, P < 0.01). Severe symptom burden was associated with a shorter time to first hospitalization (hazard ratio = 1.51, 95% CI 1.06-2.15) in adjusted models but had no association with time to nursing home placement or death.
conclusionThe homebound with severe symptom burden represents a unique cohort of patients who are at increased risk of hospitalization. Tailored symptom management via home-based primary and palliative care programs may prevent unnecessary health care utilization in this population.
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