Home care for persons with AIDS: a case-control study to identify determinants of referral to a hospital-based scheme

We conducted a multicenter, hospital-based case-control study to identify s pecific characteristics of AIDS patients which determine referral to hospit al care at home. The cases were patients referred to a hospital-based home care scheme, in the metropolitan area of Rome, during 1997. Each case was m atched with two controls. Social, demographic and clinical characteristics were collected at referral. Univariate and multivariate analysis were perfo rmed. In the study period, 119 cases and 238 controls were recruited. In lo gistic regression analysis, social characteristics were not found to affect referral to the hospital-at-home scheme. A severely impaired functional st atus - assessed by the Functional Independent Measure - identified by a sco re below 100 (Odds Ratio [OR] = 15.2, 95% confidence interval [CI] 2.8-82.7 ), and the need for prolonged intravenous therapy (OR = 12.4, 95% CI = 3.3- 46.3) were the only two independent predictors of home-care referral. We co nclude that home care, even in a period when new potent combination antiret roviral therapies are widely available, is an important integrated service component for persons with AIDS with severe functional impairment or requir ing intravenous therapy.