Influence of age and sex on hospitalization of nursing home residents: A cross-sectional study from Germany

Abstract

BackgroundNursing homes residents (NHR) are frequently transferred to hospitals. There is some evidence that male NHR are more often hospitalized than females, but the influence of age is less clear and predictors might differ between sexes. Analyses according to age groups between males and females have only been investigated once and none of the existing studies have conducted multivariate analyses stratified by sex. Aim of this study was to fill this gap.MethodsWe used data of the “Inappropriate Medication in patients with REnal insufficiency in Nursing homes” (IMREN) study, which was conducted between October 2014 and April 2015 in nursing homes in northwestern Germany (Bremen and Lower Saxony). Anonymised data was obtained by nursing staff of the participating nursing homes. All residents living in the participating care units were included. We assessed whether they were hospitalized at least once during the preceding 12 months. Cluster-adjusted multivariate logistic regression was applied to identify variables associated with hospitalizations. All analyses were stratified by sex.ResultsOf 852 residents from 21 nursing homes (mean age 83.5 years; 76.5% females), 43.1% (95% confidence intervals [95% CI]: 35.6–50.5) were hospitalized at least once during the preceding 12 months. This proportion was higher in residents institutionalized within the last 6 months compared to those with a longer length of stay (65.7% vs. 39.5%). Although not statistically significant, males were more often hospitalized than females (52.4% vs. 40.3%) and differences between sexes are particularly remarkable for age, health status and length of stay. In females, the chance of being hospitalized decreased steadily with age (OR: 2.40 [95% CI: 1.24–4.64] and 1.60 [95% CI: 1.05–2.43] for age groups <75 and 75–84 years compared to 85+ years). On the other hand, males aged 75–84 years had a statistically significant lower chance compared to 85+ years olds (OR: 0.41; 95% CI: 0.19–0.90).ConclusionsDifferences in factors associated with hospitalizations might exist between sexes. We strongly suggest that further studies on hospitalizations of NHR should stratify their analyses by sex.

Functional status and annual hospitalization in multimorbid and non-multimorbid older adults: a cross-sectional study in Southern China

“…It might be partially explained by that individuals with multimorbidity are more likely to seek treatment or to be hosptitalized due to the poor disease-related function rather than the individual characteristics. Of the social demographic factors, only gender was significantly associated with annual hospitalization and men had greater odds of hospitalization, as shown in previous studies [ 9 , 10 , 45 ]. However, no association of age on hospitalization was observed in this population, which was likely because age-related risk factors (such as comorbidities) are significant predictors of hospital admissions [ 46 ].…”

“…We firstly conducted a literature search to identify the potential factors related to annual hospitalization in older adults. This search yielded the following variables: age, gender, marital status, employment status, smoking, physical activities, body mass index, chronic conditions, functional status [ 5 – 7 , 9 , 10 , 23 – 26 ]. Therefore the variables in this study analysis included socio-demographic characteristics (age, gender, marital status, etc), lifestyle and health-related factors (smoking, physical activities, etc), functional status and hospitalization over the last one year.…”

“…Hospitalization in the last year, as a part of health service utilization, is an important and costly resource in older adult care. Numerous studies have examined the determinants of hospitalization, including, age, gender [ 9 ], multiple chronic conditions [ 5 , 10 , 11 ], and activities of daily living (ADL) limitations [ 12 ]. Several studies also have found that hospitalization, especially if repeated and prolonged, might be associated with negative consequences including an increased risk of falls [ 13 ], worsening or irreversible functional decline [ 13 – 15 ], and death [ 16 ].…”

Effects of strategies to improve general practitioner-nurse collaboration and communication in regard to hospital admissions of nursing home residents (interprof ACT): study protocol for a cluster randomised controlled trial

“…The proportion of NHRs hospitalised within 12 months is estimated to be up to 50% [ 3 – 5 ]. An absolute reduction of 15 percentage points from 50 to 35% is considered a relevant intervention effect.…”

“…In Germany, up to 50% of NHRs are admitted to hospital at least once a year [ 3 – 5 ]. The incidence is comparable to international studies with hospitalisation rates ranging from 9 to 59% [ 6 ].…”