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. 2020 Apr;134:47-53. doi: 10.1016/j.maturitas.2020.02.006. Epub 2020 Feb 19.
We investigated trends in end-of-life hospitalizations among nursing home residents (NHR) over 10 years and looked at differences between age groups and sexes as well as the length of terminal hospital stays.
Retrospective cohort study based on health insurance claims data of the AOK Bremen/Bremerhaven. All NHR aged 65 years or more who died between 2006 and 2015 were included.
We assessed the proportions of decedents who were in hospital on the day of death and during the last 3, 7, 14 and 30 days of life, stratified by two-year periods. Multiple logistic regressions were conducted to study changes over time, adjusting for covariates.
A total of 10,781 decedents were included (mean age 86.1 years, 72.1 % females). Overall, 29.2 % died in hospital, with a slight decrease from 30.3 % in 2006-2007 to 28.3 % in 2014-2015 (OR 0.86; 95 % CI 0.75-0.98). Of the 3150 terminal hospitalizations, 35.5 % lasted up to 3 days and the mean length of stay decreased from 9.0 (2006-2007) to 7.5 days (2014-2015). When looking at the last 7, 14 and 30 days of life, no changes over time were found. Male sex and younger age were associated with a higher chance of end-of-life hospitalization in almost all analyses.
End-of-life hospitalizations of NHR are common in Germany. There has been a small decrease during recent years in the proportion of in-hospital deaths, but not of hospitalizations during the last 7, 14 and 30 days of life. This might be explained by shorter durations of hospital stays.
我们调查了 10 年来养老院居民（NHR）临终住院的趋势，并比较了不同年龄组和性别的差异以及临终住院的时间长短。
基于 AOK Bremen/Bremerhaven 的健康保险索赔数据的回顾性队列研究。所有年龄在 65 岁及以上且在 2006 年至 2015 年间死亡的 NHR 均被纳入研究。
我们评估了在死亡当天以及生命的最后 3、7、14 和 30 天住院的死者比例，按两年期分层。使用多因素逻辑回归来研究随时间的变化，同时调整协变量。
共纳入 10781 名死者（平均年龄 86.1 岁，72.1%为女性）。总体而言，有 29.2%的死者在医院死亡，从 2006-2007 年的 30.3%略有下降到 2014-2015 年的 28.3%（OR 0.86；95%CI 0.75-0.98）。在 3150 例临终住院中，35.5%的住院时间为 3 天以下，平均住院时间从 2006-2007 年的 9.0 天缩短至 2014-2015 年的 7.5 天。当观察生命的最后 7、14 和 30 天时，未发现随时间的变化。在几乎所有分析中，男性和年轻的年龄与临终住院的机会更高相关。
德国 NHR 的临终住院很常见。近年来，在医院死亡的比例略有下降，但生命的最后 7、14 和 30 天的住院比例没有变化。这可能是由于住院时间缩短所致。
