title: Trend study on the association between hospital admissions and the health of Dutch older adults (1995-2009).
abstract: An increase in hospital admission rates in older people may reflect improved access to healthcare, but also declining health trends in the older population. Owing to a lack of individual-level data, the latter possibility has received little attention. The current study examines associations between health status and hospitalisation rates of older adults in the Netherlands.
  
  
  
  Observational individual-level data linked to hospital register data.
  
  
  
  Data from 1995 to 2009 from the nationally representative Longitudinal Aging Study Amsterdam were linked to the Dutch Hospital Discharge Register.
  
  
  
  A total of 5681 observations of 2520 respondents across 4 measurement points (each with a follow-up of 36 months; ages 65-88 years).
  
  
  
  The contribution of health, demographic, psychosocial and lifestyle characteristics to time trends in hospitalisation was assessed in multivariate models.
  
  
  
  Between 1995 and 2009, the percentage with 1 or more overnight admissions (planned or acute) increased slightly from 38.1% to 39.7%. This was due to an increase in acute admission only (22.2-27.0%). Increased prevalences of chronic diseases, functional limitations and polypharmacy accounted for part of the observed increase in acute admissions. In addition, a more than doubled prevalence of day admissions over time was observed (12.3-28.3%), a trend that was unrelated to changes in individual characteristics.
  
  
  
  This trend study showed a contribution of declines in population health to increases in acute hospital admissions. Since these declines did not provide a full explanation, healthcare reforms and increases in treatment possibilities in this period are likely to have contributed as well.
authors.affiliation: Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Henrike
authors.initials: H
authors.lastname: Galenkamp
authors.affiliation: Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Dorly J H
authors.initials: DJ
authors.lastname: Deeg
authors.affiliation: Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Renate T
authors.initials: RT
authors.lastname: de Jongh
authors.affiliation: Statistics Netherlands, The Hague, The Netherlands Department of Public Health, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Jan W P F
authors.initials: JW
authors.lastname: Kardaun
authors.affiliation: Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands Department of Sociology, VU University, Amsterdam, The Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: Huisman
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D016247:Information Storage and Retrieval; D008297:Male; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D019338:Polypharmacy; D015995:Prevalence
keywords: EPIDEMIOLOGY; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; PREVENTIVE MEDICINE; PUBLIC HEALTH