Aliyu Muktar H, Adediran Abayomi S, Obisesan Thomas O
Department of Medicine, Section Geriatrics, Howard University Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA.
J Natl Med Assoc. 2003 Dec;95(12):1158-67.
Healthcare for the elderly population presents enormous challenges, which are further complicated by ethnicity-related socioeconomic disparities in the United States. We set out to determine the predictors of hospital admissions in the elderly by conducting a retrospective cohort analysis of a nationally representative sample of community-dwelling individuals aged 70 and older in 1984 (n = 7541). Multivariate logistic regression analysis of data from the Longitudinal Study on Aging revealed that race, health status, type of family relationship, and activities of daily living (ADL) are significant predictors of hospitalization among the elderly. Older blacks are less likely to be admitted into the hospital, compared to their white counterparts (OR 0.68, 95%CI 0.52-0.89). Elderly persons who perceive their health status as being fair or poor are three times as likely to be hospitalized than those who perceived their health status as excellent (OR 2.99, 95%CI 2.15-4.15). Those with impairment in activities of daily living are twice as likely to be confined to the hospital than those without impairment (OR 1.78, 95%CI 1.64-1.96). Elderly persons living with nonrelatives are three times as likely to be admitted for short hospital stays than those living with spouses (OR 2.90, 95%CI 1.44-5.82). Future identification of predictors of hospital admissions in the elderly may help characterize those at risk and perhaps allow for focused and timely intervention.
为老年人口提供医疗保健面临着巨大挑战，而美国与种族相关的社会经济差距使这些挑战更加复杂。我们通过对1984年全国代表性的70岁及以上社区居住个体样本（n = 7541）进行回顾性队列分析，来确定老年人住院的预测因素。对老龄化纵向研究的数据进行多变量逻辑回归分析显示，种族、健康状况、家庭关系类型和日常生活活动（ADL）是老年人住院的重要预测因素。与白人相比，老年黑人住院的可能性较小（OR 0.68，95%CI 0.52 - 0.89）。认为自己健康状况为一般或较差的老年人住院的可能性是认为自己健康状况极佳的老年人的三倍（OR 2.99，95%CI 2.15 - 4.15）。日常生活活动有障碍的人住院的可能性是没有障碍的人的两倍（OR 1.78，95%CI 1.64 - 1.96）。与配偶同住的老年人相比，与非亲属同住的老年人短期住院的可能性是其三倍（OR 2.90，95%CI 1.44 - 5.82）。未来确定老年人住院的预测因素可能有助于确定那些有风险的人，并可能允许进行有针对性的及时干预。
