ArticleJournal of advanced nursing2023
The identification of clusters of risk factors and their association with hospitalizations or emergency department visits in home health care.
Article in Journal of advanced nursing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The trial behind it
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Who cites it
7 citing papers in PubMed, 12 citations in OpenAlex.
- Nonlinear Relationship Between Vital Signs and Hospitalization/Emergency Department Visits Among Older Home Healthcare Patients and Critical Vital Sign Cutoff for Adverse Outcomes: Application of Generalized Additive Model.Clinical nursing research · 2025Article
- Pragmatic Risk Stratification Method to Identify Emergency Department Presentations for Alternative Care Service Pathways: Registry-Based Retrospective Study Over 5 Years.Journal of medical Internet research · 2025Article
- Does synthetic data augmentation improve the performances of machine learning classifiers for identifying health problems in patient-nurse verbal communications in home healthcare settings?Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2025Article
- Activity and Participation Are Associated With Future Falls, Hospitalizations, and Emergency Visits in Community-Dwelling Older Adults.Physical therapy · 2024Article
- Natural Language Processing Applied to Clinical Documentation in Post-acute Care Settings: A Scoping Review.Journal of the American Medical Directors Association · 2024Article
- Home Healthcare Patients With Distinct Psychological, Cognitive, and Behavioral Symptom Profiles and At-Risk Subgroup for Hospitalization and Emergency Department Visits Using Latent Class Analysis.Clinical nursing research · 2023Article
- Characterising symptom clusters in patients with atrial fibrillation undergoing catheter ablation.Open heart · 2023Article
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
Abstract
aimsTo identify clusters of risk factors in home health care and determine if the clusters are associated with hospitalizations or emergency department visits.
designA retrospective cohort study.
methodsThis study included 61,454 patients pertaining to 79,079 episodes receiving home health care between 2015 and 2017 from one of the largest home health care organizations in the United States. Potential risk factors were extracted from structured data and unstructured clinical notes analysed by natural language processing. A K-means cluster analysis was conducted. Kaplan-Meier analysis was conducted to identify the association between clusters and hospitalizations or emergency department visits during home health care.
resultsA total of 11.6% of home health episodes resulted in hospitalizations or emergency department visits. Risk factors formed three clusters. Cluster 1 is characterized by a combination of risk factors related to "impaired physical comfort with pain," defined as situations where patients may experience increased pain. Cluster 2 is characterized by "high comorbidity burden" defined as multiple comorbidities or other risks for hospitalization (e.g., prior falls). Cluster 3 is characterized by "impaired cognitive/psychological and skin integrity" including dementia or skin ulcer. Compared to Cluster 1, the risk of hospitalizations or emergency department visits increased by 1.95 times for Cluster 2 and by 2.12 times for Cluster 3 (all p < .001).
conclusionRisk factors were clustered into three types describing distinct characteristics for hospitalizations or emergency department visits. Different combinations of risk factors affected the likelihood of these negative outcomes. IMPACT: Cluster-based risk prediction models could be integrated into early warning systems to identify patients at risk for hospitalizations or emergency department visits leading to more timely, patient-centred care, ultimately preventing these events. PATIENT OR PUBLIC CONTRIBUTION: There was no involvement of patients in developing the research question, determining the outcome measures, or implementing the study.
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Registered trials
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