The Impact of Depression on Discharge to Hospitals and Other Outcomes in Medicare Home Health Care Patients

The aim of this study was to determine the association of active depressive symptoms in older home health care (home care) patients and discharge to the hospital. This study was based on a cross-sectional secondary data analysis. The data were from the Montefiore Home Healthcare Agency, Bronx, New York. Patients 65 years and older who were admitted to home care in 2010 (N = 3,761) with a valid depression screen in the medical record were included. Disposition at discharge and the Patient Health Questionnaire-2 depression screen were collected from the home care nursing assessment. Demographic and clinical factors were collected from the medical record. The adjusted odds ratio (AOR) was greater for discharge resulting in hospitalization (AOR = 1.70, 95% confidence interval = [1.29, 2.25]) among those with positive depression screens compared with those with a negative screen at the time of admission. Conclusion: Active depressive symptoms at the time of admission to home care were associated with increased odds of hospitalization at discharge. Interventions to reduce depression during the home care admission may have implications for readmission rates and overall health care utilization.