The effect of home healthcare services on emergency department utilization in patients aged 65 and over

This study was retrospectively designed to evaluate the impact of home healthcare services (HHS) on the frequency of emergency department visits and hospital stay durations in individuals aged 65 and over. Among 310 patients residing in the city center of Kırşehir and registered for Home Healthcare Services (HHS) between December 2021 and May 2023, a total of 156 patients who met the study criteria were included in the analysis. Data were collected via the Hospital Information Management System (HIMS) and the Public Health Management System (PHMS) of Kırşehir Training and Research Hospital. The study examined patients' demographic characteristics, Barthel Dependency Index scores, comorbidities, and reasons for applying to HHS. The mean age of participants was 83.3 years, and 82.1% were female. The most common chronic diseases were hypertension (80.1%), diabetes mellitus (48.7%), and coronary artery disease (39.7%). The mean Barthel Index score was 75.9 with the majority of patients (80%) classified as moderately dependent. No statistically significant difference was found between the number of emergency department visits before and after enrollment in HHS (p=0.817). However, patients who applied for laboratory testing through HHS showed a statistically significant reduction in emergency visits (p=0.048). A weak but significant negative correlation was found between the number of red zone evaluations in the emergency department and the Barthel Index (Rho=-0.162, p=0.045). Similarly, a significant negative correlation was identified between intensive care unit (ICU) stay duration and Barthel scores (Rho=-0.222, p=0.006). In conclusion, while home healthcare services showed some positive effects on clinical parameters, no significant overall reduction was observed in emergency service use or hospital stay durations. These findings highlight the need to expand and restructure HHS through a multidisciplinary approach to improve its effectiveness. Keywords: Home healthcare, emergency department, elderly, Barthel Index, hospital admission