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斯德哥尔摩老年社区居民的老年综合征及后续医疗保健利用情况

Geriatric syndromes and subsequent health-care utilization among older community dwellers in Stockholm.

作者信息

Möller Jette, Rausch Christian, Laflamme Lucie, Liang Yajun

机构信息

Department of Global Public Health, Karolinska Institutet, Widerströmska, 17177 Stockholm, Sweden.

Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

出版信息

Eur J Ageing. 2021 Jan 18;19(1):19-25. doi: 10.1007/s10433-021-00600-2. eCollection 2022 Mar.

Abstract

UNLABELLED

Little is known about the long-term effect of geriatric syndromes on health-care utilization. This study aims to determine the association between geriatric syndromes and health-care utilization during a four-year period among older community dwellers. Based on the Stockholm Public Health Cohort study, a total number of 6700 community dwellers aged ≥65 years were included. From a baseline survey in 2006, geriatric syndromes were defined as having at least one of the following: insomnia, functional decline, urinary incontinence, depressive symptoms and vision impairment. Health-care utilization was identified by linkages at individual level with register data with a four-year follow-up. Cox regression was performed to estimate the associations. Compared to those without geriatric syndromes, participants with any geriatric syndromes had a higher prevalence of frequent hospitalizations, long hospital stays, frequent outpatient visits and polypharmacy in each of the follow-up years. After controlling for covariates, having any geriatric syndromes was associated with higher levels of utilization of inpatient and outpatient care as well as polypharmacy. The association was stable over time, and the fully adjusted hazard ratio (95% confidence interval) remained stable in frequent hospitalizations (from 1.89 [1.31, 2.73] in year 1 to 1.70 [1.23, 2.35] in year 4), long hospital stay (from 1.75 [1.41, 2.16] to 1.49 [1.24, 1.78]), frequent outpatient visits (from 1.40 [1.26, 1.54] to 1.33 [1.22, 1.46]) and polypharmacy (from 1.63 [1.46, 1.83] to 1.53 [1.37, 1.71]). Having any geriatric syndromes is associated with higher levels of health-care utilization among older community dwellers, and the impact of geriatric syndromes is stable over a four-year period.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at. 10.1007/s10433-021-00600-2.

摘要

未标注

关于老年综合征对医疗保健利用的长期影响,人们了解甚少。本研究旨在确定老年社区居民在四年期间老年综合征与医疗保健利用之间的关联。基于斯德哥尔摩公共卫生队列研究,纳入了6700名年龄≥65岁的社区居民。从2006年的基线调查开始,老年综合征被定义为至少具有以下之一:失眠、功能衰退、尿失禁、抑郁症状和视力障碍。通过个体层面与登记数据的关联进行四年随访来确定医疗保健利用情况。进行Cox回归以估计关联。与没有老年综合征的人相比,患有任何老年综合征的参与者在各随访年份中频繁住院、住院时间长、频繁门诊就诊和多重用药的患病率更高。在控制协变量后,患有任何老年综合征与更高水平的住院和门诊医疗利用以及多重用药相关。这种关联随时间稳定,在频繁住院(从第1年的1.89[1.31,2.73]到第4年的1.70[1.23,2.35])、住院时间长(从1.75[1.41,2.16]到1.49[1.24,1.78])、频繁门诊就诊(从1.40[1.26,1.54]到1.33[1.22,1.46])和多重用药(从1.63[1.46,1.83]到1.53[1.37,1.71])方面,完全调整后的风险比(95%置信区间)保持稳定。患有任何老年综合征与老年社区居民更高水平的医疗保健利用相关,并且老年综合征的影响在四年期间是稳定的。

补充信息

在线版本包含可在以下网址获取的补充材料。10.1007/s10433-021-00600-2。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc61/8881534/3fca10e4e213/10433_2021_600_Fig1_HTML.jpg

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