André Hajek1, Christian Brettschneider2, Marion Eisele3, Hanna Kaduszkiewicz4, Silke Mamone5, Birgitt Wiese5, Siegfried Weyerer6, Jochen Werle6, Angela Fuchs7, Michael Pentzek7, Janine Stein8, Tobias Luck8,9, Dagmar Weeg10, Edelgard Mösch10, Kathrin Heser11, Michael Wagner11,12, Martin Scherer3, Wolfgang Maier11,12, Steffi G Riedel-Heller8, Hans-Helmut König2. 1. Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center, Hamburg-Eppendorf, Germany. a.hajek@uke.de. 2. Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center, Hamburg-Eppendorf, Germany. 3. Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg-Eppendorf, Germany. 4. Medical Faculty, Institute of General Practice, Kiel University, Kiel, Germany. 5. Institute of General Practice, Hannover Medical School, Hannover, Germany. 6. Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany. 7. Medical Faculty, Institute of General Practice, Heinrich-Heine-University, Düsseldorf, Germany. 8. Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany. 9. Department of Economic and Social Sciences, University of Applied Sciences Nordhausen, Nordhausen, Germany. 10. Department of Psychiatry, Technical University of Munich, Munich, Germany. 11. Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany. 12. DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany.
Abstract
BACKGROUND: Hospitalization is a key driver of health care costs. Thus far, there are only a few longitudinal studies investigating whether changes in explanatory variables lead to hospitalization. Moreover, these longitudinal studies did not focus on individuals in highest age. AIM: The purpose of the current study was to examine the correlates of hospitalization among the oldest old in Germany longitudinally. METHODS: A multicenter prospective cohort study ["Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)", AgeQualiDe]. Primary care patients ≥ 85 years took part [n = 861 at follow-up (FU) 7, average age of 89.0 years; 85-100 years]. Two waves were used. Hospitalization in the last 6 months was used as outcome measure. Well-established scales were used to quantify the independent variables such as Instrumental Activities of Daily Living Scale, Global Deterioration Scale or Geriatric Depression Scale. RESULTS: Logistic random effects regressions showed that the probability of hospitalization in the preceding 6 months significantly increased with increases in the social network, more depressive symptoms, functional decline, and increase in chronic conditions, whereas it was not significantly associated with age, sex, marital status, education, and cognitive impairment. Social networks moderate the relationship between functional decline and hospitalization. DISCUSSION: The results of the present longitudinal study emphasize the association of depressive symptoms, functional decline, more social networks, and chronic conditions with hospitalization among the oldest old. CONCLUSIONS: Treatments with the aim to reduce or postpone these factors might also help to reduce hospitalization.
BACKGROUND: Hospitalization is a key driver of health care costs. Thus far, there are only a few longitudinal studies investigating whether changes in explanatory variables lead to hospitalization. Moreover, these longitudinal studies did not focus on individuals in highest age. AIM: The purpose of the current study was to examine the correlates of hospitalization among the oldest old in Germany longitudinally. METHODS: A multicenter prospective cohort study ["Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)", AgeQualiDe]. Primary care patients ≥ 85 years took part [n = 861 at follow-up (FU) 7, average age of 89.0 years; 85-100 years]. Two waves were used. Hospitalization in the last 6 months was used as outcome measure. Well-established scales were used to quantify the independent variables such as Instrumental Activities of Daily Living Scale, Global Deterioration Scale or Geriatric Depression Scale. RESULTS: Logistic random effects regressions showed that the probability of hospitalization in the preceding 6 months significantly increased with increases in the social network, more depressive symptoms, functional decline, and increase in chronic conditions, whereas it was not significantly associated with age, sex, marital status, education, and cognitive impairment. Social networks moderate the relationship between functional decline and hospitalization. DISCUSSION: The results of the present longitudinal study emphasize the association of depressive symptoms, functional decline, more social networks, and chronic conditions with hospitalization among the oldest old. CONCLUSIONS: Treatments with the aim to reduce or postpone these factors might also help to reduce hospitalization.
Entities:
Keywords:
Andersen’s behavioral model; Health care utilization; Hospitalization; Longitudinal study; Oldest old; Very old age
Authors: Klaus Püschel; Hans-Helmut König; André Hajek; Franziska Bertram; Fabian Heinrich; Victoria van Rüth; Benjamin Ondruschka; Benedikt Kretzler; Christine Schüler Journal: BMC Health Serv Res Date: 2021-04-07 Impact factor: 2.655
Authors: Paula C Zimbrean; Carrie L Ernst; Ariadna Forray; Scott R Beach; Mallika Lavakumar; Andrew M Siegel; Thomas Soeprono; Ann C Schwartz Journal: Psychosomatics Date: 2020-05-19 Impact factor: 2.386