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

dc.accessRightsAnonymous*
dc.contributor.authorBachmann, Nicole
dc.contributor.authorZumbrunn, Andrea
dc.contributor.authorBayer-Oglesby, Lucy
dc.date.accessioned2022-11-03T07:24:34Z
dc.date.available2022-06-22T07:10:17Z
dc.date.available2022-11-03T07:24:34Z
dc.date.issued2022
dc.description.abstractIf 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.en_US
dc.identifier.doi10.3389/fpubh.2022.871778
dc.identifier.issn2296-2565
dc.identifier.urihttps://irf.fhnw.ch/handle/11654/33578
dc.identifier.urihttps://doi.org/10.26041/fhnw-4351
dc.language.isoenen_US
dc.publisherFrontiersen_US
dc.relationSocial Inequalities and Hospitalisations in Switzerland (SIHOS), 2017-03-01
dc.relation.ispartofFrontiers in Public Healthen_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en_US
dc.subjectSIHOSen_US
dc.subjectSocial Worken_US
dc.subjectHospitalen_US
dc.subjectold ageen_US
dc.subjectchronic health conditionsen_US
dc.subjecthospital dischargeen_US
dc.subjectnursing homeen_US
dc.subjectsocial inequalityen_US
dc.subject.ddc360 - Soziale Probleme, Sozialdienste, Versicherungenen_US
dc.titleSocial 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 Switzerlanden_US
dc.type01A - Beitrag in wissenschaftlicher Zeitschrift
dc.volume10en_US
dspace.entity.typePublication
fhnw.InventedHereYesen_US
fhnw.IsStudentsWorknoen_US
fhnw.ReviewTypeAnonymous ex ante peer review of a complete publicationen_US
fhnw.affiliation.hochschuleHochschule für Soziale Arbeitde_CH
fhnw.affiliation.institutInstitut Soziale Arbeit und Gesundheitde_CH
fhnw.openAccessCategoryGolden_US
fhnw.publicationStatePublisheden_US
relation.isAuthorOfPublication9718a285-11b3-49e7-9da2-56c8506e2328
relation.isAuthorOfPublication1630cf0a-d6c6-446d-8fa5-8b1ba02a91b9
relation.isAuthorOfPublication017c0337-409d-4019-9982-c988f4fdea67
relation.isAuthorOfPublication.latestForDiscovery017c0337-409d-4019-9982-c988f4fdea67
relation.isProjectOfPublication66a52af1-4ffe-4a7d-b17b-1f254f053b8a
relation.isProjectOfPublication.latestForDiscovery66a52af1-4ffe-4a7d-b17b-1f254f053b8a
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