Social and regional factors predict the likelihood of admission to a nursing home after acute hospital stay in older people with chronic health conditions. A multilevel analysis using routinely collected hospital and census data in Switzerland
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Dateien
Autor:in (Körperschaft)
Publikationsdatum
2022
Typ der Arbeit
Studiengang
Typ
01A - Beitrag in wissenschaftlicher Zeitschrift
Herausgeber:innen
Herausgeber:in (Körperschaft)
Betreuer:in
Übergeordnetes Werk
Frontiers in Public Health
Themenheft
DOI der Originalpublikation
Link
Reihe / Serie
Reihennummer
Jahrgang / Band
10
Ausgabe / Nummer
Seiten / Dauer
Patentnummer
Verlag / Herausgebende Institution
Frontiers
Verlagsort / Veranstaltungsort
Auflage
Version
Programmiersprache
Abtretungsempfänger:in
Praxispartner:in/Auftraggeber:in
Zusammenfassung
If hospitalization becomes inevitable in the course of a chronic disease, discharge from acute hospital care in older persons is often associated with temporary or persistent frailty, functional limitations and the need for help with daily activities. Thus, acute hospitalization represents a particularly vulnerable phase of transient dependency on social support and health care. This study examines how social and regional inequality affect the decision for an institutionalization after acute hospital discharge in Switzerland. The current analysis uses routinely collected inpatient data from all Swiss acute hospitals that was linked on the individual level with Swiss census data. The study sample included 60,209 patients 75 years old and older living still at a private home and being hospitalized due to a chronic health condition in 199 hospitals between 2010 and 2016. Random intercept multilevel logistic regression was used to assess the impact of social and regional factors on the odds of a nursing home admission after hospital discharge. Results show that 7.8% of all patients were admitted directly to a nursing home after hospital discharge. We found significant effects of education level (compulsory vs. tertiary education OR = 1.16 (95% CI: 1.03–1.30), insurance class (compulsory vs. private insurance OR = 1.24 (95% CI: 1.09–1.41), living alone vs. living with others (OR = 1.64; 95% CI: 1.53–1.76) and language regions (French vs. German speaking part: OR = 0.54; 95% CI: 0.37–0.80) on the odds of nursing home admission in a model adjusted for age, gender, nationality, health status, year of hospitalization and hospital-level variance. The language regions moderated the effect of education and insurance class but not of living alone. This study shows that acute hospital discharge in older age is a critical moment of transient dependency especially for socially disadvantaged patients. Social and health care should work coordinated together to avoid unnecessary institutionalizations.
Schlagwörter
SIHOS, Social Work, Hospital, old age, chronic health conditions, hospital discharge, nursing home, social inequality
Fachgebiet (DDC)
360 - Soziale Probleme, Sozialdienste, Versicherungen
Veranstaltung
Startdatum der Ausstellung
Enddatum der Ausstellung
Startdatum der Konferenz
Enddatum der Konferenz
Datum der letzten Prüfung
ISBN
ISSN
2296-2565
Sprache
Englisch
Während FHNW Zugehörigkeit erstellt
Ja
Zukunftsfelder FHNW
Publikationsstatus
Veröffentlicht
Begutachtung
Peer-Review der ganzen Publikation
Open Access-Status
Gold
Lizenz
Zitation
BACHMANN, Nicole, Andrea ZUMBRUNN und Lucy BAYER-OGLESBY, 2022. Social and regional factors predict the likelihood of admission to a nursing home after acute hospital stay in older people with chronic health conditions. A multilevel analysis using routinely collected hospital and census data in Switzerland. Frontiers in Public Health. 2022. Bd. 10. DOI 10.3389/fpubh.2022.871778. Verfügbar unter: https://doi.org/10.26041/fhnw-4351