Impending death and the use of hospitals by the elderly.

Much attention is now focused on high users of health care. The literature indicates that elderly decedents are more often hospitalized than survivors, but little is known about the relationship of age, sex, and decedents to hospital usage. This paper uses the Manitoba Longitudinal Study on Aging to compare the hospital utilization patterns of elderly survivors and decedents. The results show that (1) the 5 per cent of the elderly who died accounted for 20 per cent of all the hospital days used by all the elderly; (2) impending death was associated with a substantial increase in the relative odds of being hospitalized and of using more than 18 hospital days; and (3) once hospitalized, the youngest decedents, who make up the largest proportion of the elderly population, spent more time in the hospital than those who were older. The findings underline the need for research into what hospitals are doing for decedents and into the quality of decedents' hospital stays.