Factors associated with healthcare utilization and trajectories in retirement village residents

Background To study healthcare utilization and trajectories, and associated factors, in older adults in retirement villages (RVs), also known as continuing care retirement communities. Methods Prospective cohort study of 578 cognitively intact residents from 34 RVs in Auckland, New Zealand (NZ). Mea...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) 2022-03, Vol.70 (3), p.754-765
Main Authors: Bloomfield, Katherine, Wu, Zhenqiang, Broad, Joanna B., Tatton, Annie, Calvert, Cheryl, Hikaka, Joanna, Boyd, Michal, Peri, Kathy, Bramley, Dale, Higgins, Ann‐Marie, Connolly, Martin J.
Format: Article
Language:English
Subjects:
Activities of Daily Living
Age
Aged
Health care
Health services utilization
Hearing loss
Hospitalization
hospitalizations
Humans
independent living
Influenza
Long-Term Care
mortality
Patient Acceptance of Health Care
Prospective Studies
Retirement
Risk Factors
Vaccination
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Summary:Background To study healthcare utilization and trajectories, and associated factors, in older adults in retirement villages (RVs), also known as continuing care retirement communities. Methods Prospective cohort study of 578 cognitively intact residents from 34 RVs in Auckland, New Zealand (NZ). Measurement: InterRAI‐Community Health Assessment (includes core items that may trigger functional supplement (FS) completion in those with higher needs, and generates clinical assessment protocols (CAPs) in those with potential unmet needs). Outcomes: time to acute hospitalization, long‐term care (LTC), and death during average 2.5 years follow‐up. Results Three hundred seven (53%) residents had acute hospitalizations, 65 (11%) moved to LTC, and 51 (9%) died over a mean of 2.5 years. Factors associated with increased risk of acute hospitalization included CAP‐falls (high risk) triggered, number of comorbidities, not having left RV in 2 weeks prior, moderate/severe hearing impairment, CAP‐cardiorespiratory conditions triggered, acute hospitalization in year prior and age, with significant hazard ratios (HR) ranging between 1.03 and 2.90. Factors associated with reduced risk of hospitalization included other (non‐NZ) European ethnicity (HR 0.73, 95% CI 0.55–0.98, p = 0.04), presence of on‐site clinic (HR 0.62, 95% CI 0.45–0.85, p = 0.003), no influenza vaccination (HR 0.56, 95% CI 0.38–0.83, p = 0.004). Factors associated with LTC transition included FS triggered (HR 3.84, 95% CI 1.92–7.66, p 
ISSN:0002-8614
1532-5415
DOI:10.1111/jgs.17602