title: Geriatric conditions as predictors of increased number of hospital admissions and hospital bed days over one year: findings of a nationwide cohort of older adults from Taiwan.
abstract: The main aim of the present study was to determine whether geriatric conditions independently predict hospital utilizations after controlling for chronic diseases and disability among community dwelling older adults. We analyzed data from a nationally representative sample of older adults aged 65 years and above by linkage of 2005 Taiwan National Health Interview Survey data (including demographic characteristics, chronic diseases, disability, and geriatric conditions such as depressive symptoms, cognitive impairment, falls, and urinary incontinence), and 2006 National Health Insurance (NHI) claims data (including hospital admissions and hospital bed days). A total of 1598 participants who consented to data linkage, were successfully linked to NHI data, and had complete data for geriatric conditions were eligible for analysis. The prevalence of depressive symptoms, cognitive impairment, falls, and urinary incontinence were 20.6%, 26.1%, 21.3% and 23.9%, respectively. Overall, 18.2% (291/1598) of participants had at least one hospital admission during 2006. After adjustment for demographics, prior hospitalization, chronic diseases and functional disability, participants with geriatric conditions had significantly more hospital admissions (incidence rate ratio=1.34; 95% confidence interval=[1.02-1.75]) and more hospital bed days (incidence rate ratio=1.72; 95% confidence interval=[1.11-2.66]) than participants without geriatric conditions. Our results highlight the high prevalence (56.3%) of one or more geriatric conditions and their independent association with excess hospital utilizations. Thus, it is of critical importance to develop programs aimed at preventing or improving these conditions to reduce hospital use in this population.
authors.affiliation: Department of Health Care Management, College of Management, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan.
authors.forename: Hui-Hsuan
authors.initials: HH
authors.lastname: Wang
authors.affiliation: Department of Health Care Management, College of Management, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan.
authors.forename: Ji-Tian
authors.initials: JT
authors.lastname: Sheu
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan; Healthy Aging Research Center, Chang Gung University, 259 Wen-Hwa 1(st) Road, Kwei-Shan, Tao-Yuan 333, Taiwan.
authors.forename: Yea-Ing Lotus
authors.initials: YI
authors.lastname: Shyu
authors.affiliation: Division of Preventive Medicine and Health Service Research, Institute of Population Health Sciences, National Health Research Institutes, #35, Keyan Road, A3223, Zhunan Town, Maoli 350, Taiwan.
authors.forename: Hsing-Yi
authors.initials: HY
authors.lastname: Chang
authors.affiliation: Department of Health Care Management, College of Management, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan; Healthy Aging Research Center, Chang Gung University, 259 Wen-Hwa 1(st) Road, Kwei-Shan, Tao-Yuan 333, Taiwan. Electronic address: clli@mail.cgu.edu.tw.
authors.forename: Chia-Lin
authors.initials: CL
authors.lastname: Li
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology*; D003863:Depression / Q000453:epidemiology*; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology*
keywords: Disability; Geriatric conditions; Hospital admission; Hospital days; Taiwan