Planned and Unplanned Hospital Admissions and Their Relationship with Social Factors: Findings from a National, Prospective Study of People Aged 76 Years or Older.

OBJECTIVE

To examine the relationship between social factors and planned and unplanned hospital admissions among older people.

DATA SOURCES/STUDY SETTING: 2011 data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) and data from the Swedish National Patient Register until December 31, 2012.

STUDY DESIGN

The study had a prospective design. Data were analyzed via Cox proportional hazard regressions with variables entered as blocks (social factors, sociodemographic and ability factors, health factors).

DATA COLLECTION

Data were collected via interviews with people aged 76+ (n = 931).

PRINCIPAL FINDINGS

Living in institutions was negatively associated with planned admissions (hazard ratio (HR): 0.29; confidence interval (CI): 0.09-0.88), while being in receipt of home help was positively associated with unplanned admissions (HR: 1.57; CI: 1.15-2.14). Low levels of social contacts and social activity predicted unplanned admissions in bivariate analyses only. Higher ability to deal with public authorities was positively associated with planned admissions (HR: 1.77; CI: 1.13-2.78) and negatively associated with unplanned admissions, although the latter association was only significant in the bivariate analysis.

CONCLUSIONS

Hospital admissions are not only due to health problems but are also influenced by the social care situation and by the ability to deal with public authorities.