Frequent users of health services among community-based older Australians: Characteristics and association with mortality.

Autor: Williamson M; Faculty of Medicine, Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia., Barr ML; Faculty of Medicine, Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia., Kabir A; Faculty of Medicine, Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia., Comino EJ; Faculty of Medicine, Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia., Goodger B; Central and Eastern Sydney Primary Health Network, Sydney, NSW, Australia., Harris-Roxas BF; Faculty of Medicine, School of Population Health, University of New South Wales, Sydney, NSW, Australia., Crozier AM; Sydney Local Health District, New South Wales Health, Sydney, NSW, Australia., Jackson T; South Eastern Sydney Local Health District, New South Wales Health, Sydney, NSW, Australia., Finch J; Sydney Local Health District, New South Wales Health, Sydney, NSW, Australia., Harris MF; Faculty of Medicine, Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia.
Jazyk: angličtina
Zdroj: Australasian journal on ageing [Australas J Ageing] 2022 Dec; Vol. 41 (4), pp. e328-e338. Date of Electronic Publication: 2022 Jun 27.
DOI: 10.1111/ajag.13110
Abstrakt: Objectives: To investigate characteristics of frequent users of general practice (GP; ≥21 visits in a year), medical specialist (≥10 visits), emergency department (ED; ≥2 presentations) and hospital services (≥2 overnight hospitalisations) and the association with mortality for people aged over 75 years.
Methods: The study included residents from Central and Eastern Sydney, Australia, aged over 75 years who participated in a large community-dwelling cohort study. Demographic, social and health characteristics data were extracted from the 45 and Up Study survey. Health service (GP, medical specialist, ED and hospitalisations) use and mortality data were extracted from linked administrative data. We calculated adjusted prevalence ratios to identify independent characteristics associated with frequent users of services at baseline (approx. 2008) and adjusted hazard ratios to assess the association between frequent users of services and mortality.
Results: Frequent users of services (GPs, medical specialists, EDs and hospitals) were more likely to be associated with ever having had heart disease and less likely to be associated with reporting good quality of life. Characteristics varied by service type. Frequent users of services were 1.5-2.0 times more likely to die within 7 years compared to those who were less frequent service users after controlling for all significant factors.
Conclusions: Our analysis found that frequent service users aged over 75 years had poorer quality of life, more complex health conditions and higher mortality and so their health service use was not inappropriate. However, better management of these frequent service users may lead to better health outcomes.
(© 2022 The Authors. Australasian Journal on Ageing published by John Wiley & Sons Australia, Ltd on behalf of AJA Inc’.)
Databáze: MEDLINE
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