Shang et al evaluated factors associated with infection-related hospitalization for a home healthcare patient. These can help to identify a high-risk patient who may require more aggressive management. The authors are from Columbia University, Appalachian State University, University of Manchester, Center from Home Care Policy & Research for New York State.
Patient selection: patient receiving home healthcare
Risk factors for significant infection (with odds ratio >= 1.5):
(1) home parenteral nutrition
(2) indwelling urinary tract catheter
(3) no, intermittent or untrained caregiver
(4) no or limited ambulation
(5) stage IV pressure or non-healing ulcer
(6) peripheral vascular disease
(7) alcohol abuse
Factors associated with a lower risk:
(1) requires assistance in medication management
Other factors to consider (not mentioned in paper):
(1) history of hospital admissions for infection
(2) diabetes, including diabetic foot ulcers
(3) COPD with frequent exacerbations
(4) at risk for aspiration
