Factors associated with the hospitalization of the elderly: a national study

Bordin, Danielle; Cabral, Luciane Patrícia Andreani; Fadel, Cristina Berger; Santos, Celso Bilynkievycz dos; Grden, Clóris Regina Blanski

doi:10.1590/1981-22562018021.180059

Abstract

Objective

:to analyze the factors associated with hospitalization among the Brazilian elderly based on multidimensional methodology.

Method:

a cross-sectional, quantitative study was performed with data from the National Health Survey (2013) population-based study. The sample was composed of 23,815 individuals over the age of 60 years. Hospitalization was considered the outcome variable and 53 independent variables were included, relating to: sociodemographic characteristics; limitations and illness; difficulties in performing basic and instrumental activities of daily living; use of health services and medical emergencies.

Results:

it was found that 10% of the elderly were hospitalized in the previous year. This event was related to: a negative self-perception of health (OR = 1.35); stopping performing any of their usual activities due to health reasons (OR = 2.14); difficulty going to the doctor (OR = 1.65) or walking alone (OR = 1.55); a recent search for a site, service or health professional for health-related care (OR = 1.47); increased frequency of annual medical visits (OR = 2.93) and household emergency (OR = 5.40).

Conclusion:

the results reinforce the fact that multiple factors are associated with the hospitalization of the elderly. The analysis of these associations has the potential to make health professionals and administrators aware of the need to improve health care for the elderly and to assist in the organization and planning of the actions of the entire health service network.

Keywords:
Hospitalization; Health Services for the Aged; Risk Factors; Indicators of Health Services

[1] Correspondence: Danielle Bordin daniellebordin@hotmail.com

Dependent variable		Total n(%)	Yes n(%)	No n(%)
Hospitalization		23815 (100)	2377 (10)	21438 (90)
Self-perception of general health condition	Positive	10461 (44)	597 (6)	9864 (94)
Self-perception of general health condition	Negative	13354 (56)	1780 (13)	11574 (87)
Failure to perform any of usual activities due to health	No	21141 (89)	1950 (9)	19488 (92)
Failure to perform any of usual activities due to health	Yes	2674 (11)	724 (27)	1653 (62)
Difficulty going to doctor alone	No	18146 (76)	1293 (7)	16853 (93)
Difficulty going to doctor alone	Yes	5669 (24)	1084 (19)	4585 (81)
Difficulty walking alone	No	21779 (91)	19936 (92)	1843 (8)
Difficulty walking alone	Yes	2036 (9)	534 (26)	1502 (74)
Recently sought a health facility, service or professional for treatment related to own health	No	5248 (22)	461 (9)	4787 (91)
	Yes	18567 (78)	1916(10)	16651 (90)
Frequency of medical consultation in last year	≥4 consultations	12467 (64)	956 (8)	11511 (92)
Frequency of medical consultation in last year	>4 consultations	7036 (36)	1421 (20)	5615 (80)
Home emergency	No	23140 (97)	2035 (9)	21105 (91)
Home emergency	Yes	675 (3)	342 (51)	333 (49)

Sociodemographic characteristics
Gender	Marital status
Age	Literacy
Skin color/ethnicity	Level of education
Live with spouse	Income
Condition and limitations of health
Self-perception of general health condition	Has been bedridden
The presence of chronic illness, physical or mental, limits usual activities in some way.	Number of days bedridden
Have stopped performing any of usual activities for health reasons	Difficulty getting around
Number of days on which stopped performing usual activities for health reasons	Difficulty seeing
Difficulties in Basic Activities of Daily Living
Presence of difficulty eating alone with a plate placed in front of you, including holding a fork, cutting food and drinking from a glass	Presence of difficulty showering alone including entering and exiting the shower or bathtub
Presence of difficulty in going to the bathroom alone including sitting and getting up from the toilet	Presence of difficulty walking from one room to another in the house
Presence of difficulty in dressing alone	Presence of difficulty lying down or getting up from the bed alone
Presence of difficulty sitting on or getting up from the chair alone
Difficulties in performing Instrumental Activities of Daily Living
Presence of difficulty shopping alone	Presence of difficulty managing finances alone
Presence of difficulty taking medicines alone	Presence of difficulty going to the doctor alone
Presence of difficulty using transport alone	Presence of difficulty managing finances alone (taking care of your own money)
Chronic diseases
Presence of any chronic, physical or mental illness	Work-related musculoskeletal disorder
Diabetes	Arthritis
Hypertension	Depression
High Cholesterol	Chronic obstructive pulmonary disease
Stroke or stroke	Cancer
Chronic spinal problem	Chronic kidney problem
Use of health services
Place where usually seeks care when you are sick	Usually seek care from the same place, doctor or health service when required
Time since last medical appointment	Place where last sought health care
Seeking a health facility, service or professional for care related to your own health in the last two weeks	Use of any integrative and complementary practice, including treatment such as acupuncture, homeopathy, medicinal plants and phytotherapy etc.
Had drugs prescribed at the last visit	Home emergency
Reason for the demand of the service
Habits
Consume alcoholic drinks	Perform physical activity
Use tobacco

Variable	Odds Ratio (OR)
Self-perception of overall health
Positive	1.00
Negative	1.35
Failure to perform any of usual activities due to health
No	1.00
Yes	2.14
Difficulty going to doctor alone
No	1.00
Yes	1.65
Difficulty walking alone
No	1.00
Yes	1.55
Recently sought a health facility, service or professional for treatment related to own health.
No	1.00
Yes	1.47
Frequency of medical consultation in last year
Up to 04 consultations per year	1.00
Over 04 consultations per year	2.93
Home emergency
No	1.00
Yes	5.40