title: Socioeconomic status and hospitalization in the very old: a retrospective study.
abstract: BACKGROUND
  Socioeconomic status could affect the demand for hospital care. The aim of the present study was to assess the role of age, socioeconomic status and comorbidity on acute hospital admissions among elderly.
  
  
  METHODS
  We retrospectively examined the discharge abstracts data of acute care hospital admissions of residents in Rome aged 75 or more years in the period 1997-2000. We used the Hospital Information System of Rome, the Tax Register, and the Population Register of Rome for socio-economic data. The rate of hospitalization, modified Charlson's index of comorbidity, and level of income in the census tract of residence were obtained. Rate ratios and 95% confidence limits were computed to assess the relationship between income deciles and rate of hospitalization. Cross-tabulation was used to explore the distribution of the index of comorbidity by deciles of income. Analyses were repeated for patients grouped according to selected diseases.
  
  
  RESULTS
  Age was associated with a marginal increase in the rate of hospitalization. However, the hospitalization rate was inversely related to income in both sexes. Higher income was associated with lower comorbidity. The same associations were observed in patients admitted with a principal diagnosis of chronic condition (diabetes mellitus, heart failure, chronic obstructive pulmonary disease) or stroke, but not hip fracture.
  
  
  CONCLUSIONS
  Lower social status and associated comorbidity, more than age per se, are associated with a higher rate of hospitalization in very old patients.
authors.affiliation: Geriatric Medicine, University Campus Bio-Medico, Rome, Italy. r.antonelli@unicampus.it
authors.forename: Raffaele
authors.initials: R
authors.lastname: Antonelli-Incalzi
authors.forename: Carla
authors.initials: C
authors.lastname: Ancona
authors.forename: Francesco
authors.initials: F
authors.lastname: Forastiere
authors.forename: Valeria
authors.initials: V
authors.lastname: Belleudi
authors.forename: Andrea
authors.initials: A
authors.lastname: Corsonello
authors.forename: Carlo A
authors.initials: CA
authors.lastname: Perucci
mesh_terms: D000208:Acute Disease / Q000145:classification / Q000453:epidemiology; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000145:classification / Q000453:epidemiology; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007182:Income / Q000706:statistics & numerical data / Q000639:trends; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data / Q000639:trends; D012042:Registries; D012189:Retrospective Studies; D012384:Rome / Q000453:epidemiology; D012923:Social Class