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Factors Associated With Hospitalization Before the Start of Long-Term Care Among Elderly Disabled People

Arandelovic, Andelija; Acampora, Anna; Federico, Bruno; Profili, Francesco; Francesconi, Paolo; Damiani, Gianfranco

The Journal for Healthcare Quality (JHQ): September/October 2019 - Volume 41 - Issue 5 - p 306–316
doi: 10.1097/JHQ.0000000000000201
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ABSTRACT The growing number of elderly people with functional limitations, cognitive impairment, and disability is an organizational challenge for the health care sector. This study investigated the factors associated with hospitalization in the period between evaluation and the start of a long-term care (LTC) program for patients on the waiting list. A population-based historical cohort study was performed using data extracted from different administrative databases. The cohort included disabled individuals 65 years and older who were evaluated for entrance into an LTC program between January 1, 2012, and December 31, 2013, in Tuscany, Italy. The sample consisted of 11,429 subjects. The characteristics positively associated with hospital admission were residence zone {urban incidence rate ratio (IRR) = 0.83 (95% confidence interval [CI] 0.74–0.94)}, number of prescribed drugs IRR = 1.01 (95% CI 1.00–1.02), a Charlson Comorbidity Index of 2 IRR = 1.44 (95% CI 1.26–1.64), and lower social conditions IRR = 0.99 (95% CI 0.98–1.00). The rate of hospitalization for patients with heart failure, chronic obstructive pulmonary disease, and dementia was higher than for patients without these diseases. Our results indicate that it may be possible to predict factors that can lead to hospitalization before the start of an LTC program.

For more information on this article, contact Andelija Arandelovic, andelija.arandelovic@manchester.ac.uk.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article at (www.jhqonline.com).

© 2019 National Association for Healthcare Quality
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