What lies beneath: a retrospective, population-based cohort study investigating clinical and resource-use characteristics of institutionalized older people in Catalonia.

Autor: Amblàs-Novellas J; Geriatric and Palliative Care Department, Hospital Universitari de la Santa Creu and Hospital Universitari de Vic, Barcelona, Spain.; Chair and Department of Palliative Care, University of Vic, Barcelona, Spain.; Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Universitat de Vic - University of Vic-Central University of Catalonia (UVIC-UCC), 08500, Vic, Spain.; Chronic Care Program, Ministry of Health, Generalitat de Catalunya, Travessera de les Corts, 131-159 08028, Barcelona, Catalonia, Spain., Santaeugènia SJ; Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Universitat de Vic - University of Vic-Central University of Catalonia (UVIC-UCC), 08500, Vic, Spain. sebastia.santaeugenia@gencat.cat.; Chronic Care Program, Ministry of Health, Generalitat de Catalunya, Travessera de les Corts, 131-159 08028, Barcelona, Catalonia, Spain. sebastia.santaeugenia@gencat.cat., Vela E; Unitat d'Informació i Coneixement, Servei Català de la Salut, Barcelona, Catalonia, Spain., Clèries M; Unitat d'Informació i Coneixement, Servei Català de la Salut, Barcelona, Catalonia, Spain., Contel JC; Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Universitat de Vic - University of Vic-Central University of Catalonia (UVIC-UCC), 08500, Vic, Spain.; Chronic Care Program, Ministry of Health, Generalitat de Catalunya, Travessera de les Corts, 131-159 08028, Barcelona, Catalonia, Spain.
Jazyk: angličtina
Zdroj: BMC geriatrics [BMC Geriatr] 2020 Jun 02; Vol. 20 (1), pp. 187. Date of Electronic Publication: 2020 Jun 02.
DOI: 10.1186/s12877-020-01587-8
Abstrakt: Background: Planning population care in a specific health care setting requires deep knowledge of the clinical characteristics of the target care recipients, which tend to be country specific. Our area virtually lacks any descriptive, far-reaching publications about institutionalized older people (IOP). We aimed to investigate the demographic and clinical characteristics of institutionalized older people (IOP) ≥65 years old and compare them with those of the rest of the population of the same age.
Methods: Retrospective analysis (total cohort approach) of clinical and resource-use characteristics of IOP and non-IOP older than 65 years in Catalonia (North-East Spain). Variables analysed included age and sex, diagnoses, morbidity burden-using Adjusted Morbidity Groups (GMA, Grupos de Morbilidad Ajustada)-, mortality, use of resources, and medications taken. All data were obtained from the administrative database of the local healthcare system.
Results: This study included 93,038, 78,458, 68,545 and 67,456 IOP from 2011, 2013, 2015 and 2017, respectively. In this interval, an increase in median age (83 vs. 87 years), in women (68.64% vs. 72.11%) and in annual mortality (11.74% vs. 20.46%) was observed. Compared with non-IOP (p < 0.001 in all comparisons), IOP showed a higher annual mortality (20.46% vs. 3.13%), a larger number of chronic diseases (specially dementia: 46.47% vs. 4.58%), higher multimorbidity (15.2% vs. 4.2% with GMA of maximum complexity), and annual admissions to acute care (47.6% vs. 27.7%) and skilled nursing facilities (27.8% vs. 7.4%), mean length of hospital stay (10.0 vs. 7.2 days) and mean of medications taken (11.7 vs. 8.0).
Conclusions: There is a growing gap between the clinical and demographic characteristics of age-matched IOP and non-IOP, which overlaps with a higher mortality rate of IOP. The profile of resources utilization of IOP compared with non-IOP strongly suggests a deficiency of preventive actions and stresses the need to rethink the care model for IOP from a social and health care perspective.
Databáze: MEDLINE
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