Hoffmann Falk, Allers Katharina
Carl von Ossietzky University Oldenburg, Department of Health Services Research, Oldenburg, Germany.
Carl von Ossietzky University Oldenburg, Department of Health Services Research, Oldenburg, Germany.
Maturitas. 2017 Aug;102:50-55. doi: 10.1016/j.maturitas.2017.04.017. Epub 2017 Apr 30.
We examined hospitalization rates for nursing home residents before and after their entry to the home, stratified by sex and age.
A cohort study was conducted using data from a large health insurance fund on 127,227 residents aged 65 years and over newly admitted to a nursing home between January 1, 2010, and December 31, 2014.
We assessed hospitalization rates and proportions being hospitalized in 6-month intervals one year before nursing home placement and up to 5 years thereafter. Multiple Poisson regression models were fitted to calculate relative risks (RR).
Mean age was 84.0 years and 74.6% of the cohort were females. Hospitalization rates were 194.4 per 100 person-years (PY) in the 12 months before entry to the nursing home and 120.0 per 100 PY thereafter. Rates were highest immediately before entry in both sexes. The influence of age was most pronounced in the 12-7 months before entry (RR: 2.37 for 65-74 vs. 95+ years) and declined thereafter (1.29-1.38 up to month 24 after entry). In contrast, the influence of sex was greater after entry (RR: 1.13 for males vs. females in the 12-7 months before and 1.23-1.31 up to month 24 after entry).
Hospitalization rates of nursing home residents are much higher in Germany than in other Western countries. We have provided some insight into the influence of age and sex on hospitalization rates, which varied over the period (time before and after entry to the nursing home) analyzed. We urgently recommend that future studies on the hospitalization of residents stratify their analyses by sex, age and period.
我们对养老院居民入住前后的住院率进行了研究，并按性别和年龄进行分层。
采用一项队列研究，数据来自一个大型健康保险基金，涉及2010年1月1日至2014年12月31日期间新入住养老院的127227名65岁及以上居民。
我们评估了养老院安置前一年以及此后长达5年期间每6个月的住院率和住院比例。采用多个泊松回归模型计算相对风险（RR）。
队列的平均年龄为84.0岁，74.6%为女性。入住养老院前12个月的住院率为每100人年194.4次，此后为每100人年120.0次。入住前男女的住院率均最高。年龄的影响在入住前12 - 7个月最为显著（65 - 74岁与95岁及以上相比，RR为2.37），此后下降（入住后第24个月时为1.29 - 1.38）。相比之下，性别的影响在入住后更大（入住前12 - 7个月男性与女性相比，RR为1.13，入住后第24个月时为1.23 - 1.31）。
德国养老院居民的住院率远高于其他西方国家。我们深入了解了年龄和性别对住院率的影响，这种影响在分析的时间段（入住养老院前后）有所不同。我们迫切建议未来关于居民住院情况的研究按性别、年龄和时间段进行分层分析。
