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
Loading...
Author (Corporation)
Publication date
2022
Typ of student thesis
Course of study
Collections
Type
01A - Journal article
Editors
Editor (Corporation)
Supervisor
Parent work
Frontiers in Public Health
Special issue
DOI of the original publication
Link
Series
Series number
Volume
10
Issue / Number
Pages / Duration
Patent number
Publisher / Publishing institution
Frontiers
Place of publication / Event location
Edition
Version
Programming language
Assignee
Practice partner / Client
Abstract
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.
Keywords
SIHOS, Social Work, Hospital, old age, chronic health conditions, hospital discharge, nursing home, social inequality
Subject (DDC)
360 - Soziale Probleme, Sozialdienste, Versicherungen
Event
Exhibition start date
Exhibition end date
Conference start date
Conference end date
Date of the last check
ISBN
ISSN
2296-2565
Language
English
Created during FHNW affiliation
Yes
Strategic action fields FHNW
Publication status
Published
Review
Peer review of the complete publication
Open access category
Gold
Citation
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