Dependency Levels and Related Factors of Individuals Receiving Home Based Health Care in Turkey

Background: The need for health services is increasing steadily and hospital resources to meet this need are quite limited. Patients who need home based health care (HBHC) constitute a significant part of this need. The aim of this study was to determine the dependence levels and related factors of HBHC patients in Istanbul. Methods: Our descriptive study was carried out with 134 patients who were enrolled between January 1st and May 15th of 2016 due to the need for HBHC. Sociodemographic information, data on chronic diseases and related to the need for HBHC, were evaluated by means of the questionnaire, and dependence levels were evaluated with Barthel Index. Results: The mean age was 77.5±14.7 years. The group consisted of 61.2% women; 61.9% were single or in widowhood and 43.3% were illiterate. Some 86.6% of the patients who received HBHC services were looked after by one of their family members. The most common diseases were hypertension (59.0%), diabetes mellitus (26.1%), stroke (25.4%), and Alzheimer's disease (23.9%). The most common reason for applying to receive HBHC was neurologic diseases with 56.0%, and old age with 29.8%. Patients were found as fully dependent on others for bathing (97.0%), climbing stairs (77.6%), personal care (66.4%), dressing and undressing (56.0%), and for the toilet (56.7%). According to the Barthel Index, 50.7% of the group was fully dependent, and 29.9% of the group showed more advanced dependency. In those with Alzheimer's disease, the likelihood of being advanced or fully dependent was 9.9 times higher (95% CI: 1.16-85.47; p=0.036). Conclusion: The level of dependency in HBHC services is higher than many other specific groups. Alzheimer's disease was found to be the most important factor that increasing the need for HBHC. Therefore, more comprehensive service delivery with a multidisciplinary team approach is required.