ArticleInternational journal of older people nursing2026
The Association Between Home-Visit Nursing Use and the Incidence of Potentially Avoidable Hospitalisation and Its Duration Among Community-Dwelling Older People: A 12-Month Prospective Cohort Study.
Article in International journal of older people nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPreventing potentially avoidable hospitalisation (PAH) and reducing its duration are crucial to allow community-dwelling older people to age at home. In Japan, homecare services, which include a variety of services such as home help, home-based rehabilitation and home-visit nursing, are covered by medical and long-term care insurance and coordinated by care managers. Although home-visit nursing is essential in homecare, studies investigating the association between the use of home-visit nursing and the incidence and duration of PAH remain limited.
objectiveTo examine the association between home-visit nursing use and the incidence and duration of PAH among community-dwelling older people.
designThis was a 12-month prospective cohort study. STUDY SETTINGS: 47 home-visit nursing agencies and 73 care management offices across Japan.
participantsOlder people (≥ 75 years) receiving homecare services.
methodsUsing online questionnaires, home-visit nurses and care managers reported older people's demographics, health status and PAH events over 12 months, as well as the state of using home-visit nursing (users or non-users). The incidence of PAH was dichotomised as either 'none' or 'one and more', due to heavy skewing. To examine PAH days, the rate of observed days was used due to the variability in the total observation period. Poisson regression and multivariate linear regression analyses were applied.
resultsOf the 1450 participants initially recruited, 781 with complete dataset were included in the PAH incidence analysis. Of these, 81.0% were home-visit nursing users. Mean participant age was 85.3 years (standard deviation: 6.1; range: 75-103), and 58.8% were female. The incidence rate ratio (IRR) of PAH was lower among home-visit nursing users compared with non-users (IRR, 0.63; 95% confidence interval [CI]: 0.41-0.95). Among 110 participants with PAH, there was no statistically significant difference in the rate of PAH days between home-visit nursing users and non-users (β = -0.65, 95% CI: -8.35-4.50).
conclusionsThese results suggest that home-visit nursing is associated with a lower incidence of PAH among older people; however, it is not associated with the duration of hospital stay once PAH occurs. For community-dwelling older people with homecare services, home-visit nursing may contribute to sustaining lives at home without PAH. IMPLICATIONS FOR PRACTICE: Home-visit nursing may help support community-dwelling older people in remaining at home by minimizing the occurrence of PAH.
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