Highlights
- •Hospital stay in the last year of life differs by gender for adults 85+ years.
- •Women admitted for influenza are associated with shorter length of stay in hospital.
- •Men with poor health behaviours, falls and organ failure have longer length of stay
Abstract
Objectives
Explore characteristics of hospital use for adults aged 85 and over in their last
year of life and examine factors associated with cumulative overnight length of stay
(LOS).
Data source/study setting
NSW 45 and Up Study linked with hospital data.
Study design
Longitudinal cohort study.
Methods
Quantile regression models were performed for men and women (N = 3145) to examine heterogeneity in predictors of overnight hospital admissions.
Coefficients were estimated at the 25th, 50th, 75th and 90th percentiles of the LOS
distribution.
Principal findings
86% had at least one hospitalisation in their last year of life, with 60% dying in
hospital. For men, first admission for organ failure was associated with a 26 day
increase at the 90th LOS percentile, and a 0.22 day increase at the 10th percentile
compared to men with cancer. Women admitted with influenza had decreased LOS of 20.5 days
at the 75th percentile and 6 to 8 fewer days at the lower percentiles compared to
those women with cancer.
Conclusions
Poor health behaviours were a major driver of highest LOS among older men, pointing
to opportunities to achieve health care savings through prevention. For older women,
influenza was associated with shorter LOS, which could be an indicator of the high
and rapid mortality rates at older ages, and may be easily prevented. Other factors
associated with LOS among women, included where they lived before they were admitted,
and discharge destination.
Keywords
Abbreviations:
LOS (Length of stay), NSW (New South Wales), BMI (Body mass index), ICD-10 (International Statistical Classification of Diseases and Related Health Problems (10th revision)), COD (Cause of death), OLS (Ordinal least square), IQR (Inter-quartile range)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 22, 2019
Accepted:
February 18,
2019
Received in revised form:
January 31,
2019
Received:
June 15,
2017
Identification
Copyright
© 2019 Published by Elsevier B.V. on behalf of European Federation of Internal Medicine.
