Department of Health Data Science, Yokohama City University, Yokohama, Japan.
Medical Policy Division, Medical Care Bureau, City of Yokohama, Yokohama, Japan.
Geriatr Gerontol Int. 2022 Jun;22(6):483-489. doi: 10.1111/ggi.14387. Epub 2022 Apr 16.
Urbanization and ageing are worldwide issues for healthcare providers. In particular, older adults aged 90 years and older have increased cognitive impairment and lower daily functioning than younger adults. However, the healthcare use of the oldest old remains unclear. This study aimed to describe the healthcare use of the oldest old compared with younger older adults in a city using the ecology of medical care model.
We conducted a cross-sectional study. This study targeted all residents aged 75 years and older registered in a city in Japan for one year. We described healthcare use per 1000 inhabitants over a 1-month period and included: outpatient visits, emergency department visits, hospitalizations, home visits, home care services, and facility services. We also compared healthcare use among older adults aged 75-89 years and 90 years and older.
We described the healthcare use of 454 366 (male/female: 186 177/268 189) older adults. The numbers of persons per 1000 residents who used healthcare resources at least once in 1 month (75-89 years/90 years and older) were: outpatient clinic visits, 622/570; hospital outpatient visits, 300/263; advanced treatment hospital outpatient visits, 16/6; emergency department visits, 10/27; hospitalizations, 45/96; advanced treatment hospital hospitalizations, 2/1; planned home visits, 36/228; urgent home visits, 6/38; home care services, 173/533; and facility services, 32/178.
The results revealed that older adults over 90 years had more hospitalizations, emergency department visits and home visits, and used facility/home care services more compared with older adults aged 75-89 years. The results provide a useful benchmark for healthcare use estimation. Geriatr Gerontol Int 2022; 22: 483-489.
城市化和人口老龄化是全球医疗保健提供者面临的问题。特别是 90 岁及以上的老年人比年轻成年人认知障碍和日常功能下降的发生率更高。然而，对于最年长老年人的医疗保健使用情况尚不清楚。本研究旨在使用医疗保健生态学模型描述城市中最年长老年人与较年轻老年人的医疗保健使用情况。
我们进行了一项横断面研究。该研究的目标人群为日本某城市中所有登记在册的年龄在 75 岁及以上的居民，为期一年。我们描述了在一个月内每 1000 名居民的医疗保健使用情况，包括：门诊就诊、急诊就诊、住院、家访、家庭护理服务和机构服务。我们还比较了 75-89 岁和 90 岁及以上老年人的医疗保健使用情况。
我们描述了 454366 名（男/女：186177/268189）老年人的医疗保健使用情况。每 1000 名居民中至少有 1 个月内使用医疗资源的人数（75-89 岁/90 岁及以上）为：门诊就诊 622/570；医院门诊就诊 300/263；高级治疗医院门诊就诊 16/6；急诊就诊 10/27；住院治疗 45/96；高级治疗医院住院治疗 2/1；计划家访 36/228；紧急家访 6/38；家庭护理服务 173/533；机构服务 32/178。
结果显示，90 岁以上的老年人与 75-89 岁的老年人相比，住院治疗、急诊就诊和家访更多，并且使用机构/家庭护理服务更多。这些结果为医疗保健使用估计提供了有用的基准。国际老年医学和老年学杂志 2022；22：483-489。
