Risk Factors for Emergency Department Visits or Hospitalizations Among Older Adults With Urinary Incontinence in Home Health Care

Abstract

Purpose To determine factors associated with emergency department (ED) visits or hospitalizations among older adults with urinary incontinence (UI) in home health care (HHC). Method We analyzed HHC episode data for adults aged ≥65 years with UI. Five clusters were identified a priori using hierarchical clustering of symptoms extracted from clinical notes using natural language processing. Chi-square tests and backward stepwise logistic regression identified cluster, sociodemographic, and clinical variables associated with outcomes. Results A total of 39,179 HHC episodes reflecting 29,981 patients were included. Episodes in the anxiety, all symptoms, dizziness-anxiety, and constipation-anxiety-dizziness clusters were more likely to result in ED visits/hospitalizations versus the no symptoms cluster. Episodes for Black and Hispanic patients had higher odds of these outcomes than White patients. Episodes for patients with skin ulcers and prior urinary tract infections had higher odds of these outcomes than those without these characteristics. Conclusion Older adults with UI require comprehensive care addressing complex factors contributing to ED visits/hospitalizations. [ Journal of Gerontological Nursing, 51 (6), 38–47.]