2014 年 37 巻 7 号 p. 1228-1233
To assess the reasons for barriers to home discharge by determining whether they were predicted by medication, clinical variables, and patient characteristics, the retrospective cohort study of 282 patients discharged from Kanazawa Red Cross Hospital in Kanazawa, Japan from January 2011 to December 2012 was performed. The percentage of patients discharged was 67.4%. By multivariate logistic analysis, significant differences in home discharge destination were determined by six factors: the duration of hospitalization before discharge (odds ratio (OR) 0.993; 95% 95% confidence interval (CI) 0.988–0.999), the presence of excretion assistance (OR 0.115; 95% CI 0.043–0.308), individual payment of medical expense (OR 0.344; 95% CI 0.146–0.811), the degree of independent living for the demented elderly (OR4.570; 95% CI 1.969–10.604), presence of the primary caregiver (OR 8.638; 95% CI 3.121–23.906), and admission to a hospital from home (OR 5.483; 95% CI 2.589–11.613). This study suggests that necessity of excretion assistance, long duration of hospitalization, and high individual payment of medical expense were barriers to home discharge. In contrast, three factors i.e., admission to a hospital form home, low degree of independent living for the demented elderly, and presence of the primary caregiver, favored home discharge. The relation between a patient’s status (cognitive status and incontinence) and a caregiver has an important effect on the home discharge. However, medication characteristics appeared to have little effect on recuperation destination.
