Hospital and outpatient clinic utilization among older people in the 3-5 years following the initiation of continuing care: a longitudinal cohort study

• Published in: BMC health services research 2011-05, Vol.11 (1), p.136-136, Article 136
• Main Authors: Condelius, Anna, Hallberg, Ingalill R, Jakobsson, Ulf
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Analysis; Analysis of Variance; Cohort Studies; Continuity of Patient Care - statistics & numerical data; Female; Health aspects; Health Care Service and Management, Health Policy and Services and Health Economy; Health Sciences; Health Services for the Aged - statistics & numerical data; Health Services for the Aged - utilization; Health Services Needs and Demand - statistics & numerical data; Hospital Care; Hospital Stay; Hospitalization - statistics & numerical data; Humans; Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi; Hälsovetenskap; Informal Care; Male; Medical and Health Sciences; Medical care; Medicin och hälsovetenskap; Outpatient Care; Outpatients - statistics & numerical data; Pilot Projects; Pressure Ulcer; Risk Assessment - methods; Sweden; Utilization
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/1472-6963-11-136

Few studies have investigated the subsequent rate of hospital and outpatient clinic utilization in those who receive continuing care and have documented frequent usage over one year. Such knowledge may be helpful in identifying those who would benefit from preventive interventions. The aim of this study was to investigate and compare the subsequent rate of hospital and outpatient clinic utilization among older people with 0, 1, 2, 3 or more hospital stays in the first year following the initiation of continuing care. A further aim was to compare these groups regarding demographic data, health complaints, functional and cognitive ability, informal care and mortality. A total of 1079 people, aged 65 years or older, who received a decision regarding the initiation of continuing care during the years 2001, 2002 or 2003 were investigated. Four groups were created based on whether they had 0, 1, 2 or ≥ 3 hospital stays in the first year following the initiation of continuing care and were investigated regarding the rate of hospital and outpatient clinic utilization in the subsequent 3-5 years. Fifty seven percent of the sample had no hospital stay during the first year following the initiation of continuing care, 20% had 1 stay, 10% had 2 stays and 13% had three or more hospital stays (range: 3-13). Those with ≥ 3 hospital stays in the first year continued to have the significantly highest rate of hospital and outpatient care utilization in the subsequent years. This group accounted for 57% of hospital stays in the first year, 27% in the second year and 18% in the third year. In this group the risk of having ≥ 3 hospital stays in the second year was 27% and 12% in the third year. There is a clear need for interventions targeted on prevention of frequent hospital and outpatient clinic utilization among those who are high users of hospital care in the first year after the initiation of continuing care. Perhaps an increased availability of medically skilled staff in the day to day care of these people in the municipalities could prevent frequent hospital and outpatient clinic utilization, especially hospital readmissions.